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Can we predict the compensatory hyperhidrosis following a thoracic sympathectomy?

  • Murat KaraEmail author
  • Selcuk Kose
  • Can Ertug Cayirci
  • Ayhan Koksal
Original Article
  • 14 Downloads

Abstract

Background

Primary hyperhidrosis is a functionally and socially disabling condition resulting in social embarrassment and low quality of life. Thoracic sympathectomy is a definitive choice of treatment with favorable results. However, patients may face another embarrassing condition following surgery as compensatory hyperhidrosis which has no definitive treatment. The predictors of compensatory hyperhidrosis are controversial and remain unclear.

Patients and methods

A total of 74 patients underwent a videothoracoscopic sympathectomy for primary hyperhidrosis. We statistically analyzed our patients with correlations and uni-multivariate logistic regression models to outline the possible predictors of compensatory hyperhidrosis.

Results

A total of 45 (60.8%) patients had compensatory hyperhidrosis. The correlations showed that patients, with age greater than 21 years (P = 0.018), with body mass index (BMI) greater than 22 kg / m2 (P = 0.045), with isolated facial hyperhidrosis (P = 0.044), and with smoking status (P = 0.015), had significantly greater rates of compensatory hyperhidrosis. Similarly, the significant univariate predictors of compensatory hyperhidrosis were age > 21 (P = 0.020), BMI > 22 kg / m2 (P = 0.048), and the presence of smoking status (P = 0.015). Multivariate analysis revealed only smoking as a predictor within the threshold of significance (P = 0.078).

Conclusion

The clinical predictors of compensatory hyperhidrosis following a thoracic sympathectomy appear as older age, greater body mass index, and smoking.

Keywords

Primary hyperhidrosis Sympathectomy Compensatory hyperhidrosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Our study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This is a retrospective study on a series of patients who underwent a thoracic sympathectomy for primary hyperhidrosis and “for this type of study formal consent is not required.

References

  1. 1.
    Panhofer P, Zacherl J, Jakesz R, Bischof G, Neumayer C. Improved quality of life after sympathetic block for upper limb hyperhidrosis. Br J Surg. 2006;93:582–6.CrossRefGoogle Scholar
  2. 2.
    Schmidt J, Bechara FG, Altmeyer P, Zirngibl H. Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating. Ann Thorac Surg. 2006;81:1048–55.CrossRefGoogle Scholar
  3. 3.
    Gossot D, Galetta D, Pascal A, et al. Long – term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg. 2003;75:1075–9.CrossRefGoogle Scholar
  4. 4.
    Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91:1642–8.CrossRefGoogle Scholar
  5. 5.
    Miller DL, Bryant AS, Force SD, Miller JI Jr. Effect of sympathectomy level on the incidence of compensatory hyperhidrosis after sympathectomy for palmar hyperhidrosis. J Thorac Cardiovasc Surg. 2009;138:581–5.CrossRefGoogle Scholar
  6. 6.
    Hwang JJ, Kim DH, Hong YJ, Lee DY. A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis. Surg Today. 2013;43:397–402.CrossRefGoogle Scholar
  7. 7.
    Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol. 2004;51:274–86.CrossRefGoogle Scholar
  8. 8.
    Shoenfeld Y, Shapiro Y, Machtiger A, Magazanik A. Sweat studies in hyperhidrosis palmaris and plantaris. A survey of 60 patients before and after cervical sympathectomy. Dermatologica. 1976;152:257–62.CrossRefGoogle Scholar
  9. 9.
    Lin CC, Telaranta T. Lin – Telaranta classification: the importance of different procedures for different indications in sympathetic surgery. Ann Chir Gynaecol. 2001;90:161–6.Google Scholar
  10. 10.
    Yazbek G, Wolosker N, Kauffman P, Campos JR, Puech-Leao P, Jatene FB. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinic (Sao Paulo). 2009;64:743–9.CrossRefGoogle Scholar
  11. 11.
    Bryant AS, Cerfolio RJ. Satisfaction and compensatory hyperhidrosis rates 5 years and longer after video – assisted thoracoscopic sympathotomy for hyperhidrosis. J Thorac Cardiovasc Surg. 2014;147:1160–3.CrossRefGoogle Scholar
  12. 12.
    Katara AN, Domino JP, Cheah WK, So JB, Ning C, Lomanto D. Comparing T2 and T2-T3 ablation in thoracoscopic sympathectomy for palmar hyperhidrosis: a randomized control trial. Surg Endosc. 2007;21:1768–71.CrossRefGoogle Scholar
  13. 13.
    Kopelman D, Hashmonai M. The correlation between the method of sympathetic ablation for palmar hyperhidrosis and the occurrence of compensatory hyperhidrosis: a review. World J Surg. 2008;32:2343–56.CrossRefGoogle Scholar
  14. 14.
    Bell D, Jedynak J, Bell R. Predictors of outcome following endoscopic thoracic sympathectomy. ANZ J Surg. 2014;84:68–72.CrossRefGoogle Scholar
  15. 15.
    Ibrahim M, Menna C, Andreetti C, et al. Bilateral single-port sympathectomy: Long-term results and quality of life. Biomed Res Int. 2013: 348017 doi:  https://doi.org/10.1155/2013/348017
  16. 16.
    Rodriguez PM, Freixinet JL, Hussein M, et al. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients. Eur J Cardiothorac Surg. 2008;34:514–9.CrossRefGoogle Scholar
  17. 17.
    Baumgartner FJ, Reyes M, Sarkisyan GG, Iglesias A, Reyes E. Thoracoscopic sympathicotomy for disabling palmar hyperhidrosis: A prospective randomized comparison between two levels. Ann Thorac Surg. 2011;92:2015–9.CrossRefGoogle Scholar
  18. 18.
    Mohamed TS, Jayakar SS, Hamouda AK. Orthosteric and Allosteric Ligands of Nicotinic Acetylcholine Receptors for Smoking Cessation. Front Mol Neurosci. 2015;8:71.CrossRefGoogle Scholar
  19. 19.
    Kargi AB. Plantar sweating as an indicator of lower risk of compensatory sweating after thoracic sympathectomy. Thorac Cardiovasc Surg. 2017;65:479–83.CrossRefGoogle Scholar
  20. 20.
    Stefaniak T, Cwigon M, Laski D. In the search for the treatment of compensatory sweating. Sci World J. 2012; 134547 doi:  https://doi.org/10.1100/2012/134547
  21. 21.
    Loscertales J, Congregado M, Jimenez-Merchan R, et al. Sympathetic chain clipping for hyperhidrosis is not a reversible procedure. Surg Endosc. 2012;26:1258–63.CrossRefGoogle Scholar
  22. 22.
    Hynes CF, Yamaguchi S, Bond CD, Marshall MB. Reversal of sympathetic interruption by removal of clips. Ann Thorac Surg. 2015;99:1020–3.CrossRefGoogle Scholar
  23. 23.
    Connery CP. Reconstruction of the sympathetic chain. Thorac Surg Clin. 2016;26:427–34.CrossRefGoogle Scholar

Copyright information

© Indian Association of Cardiovascular-Thoracic Surgeons 2018

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryIstanbul University School of MedicineIstanbulTurkey
  2. 2.Department of Thoracic SurgeryBakirkoy Research and Training HospitalIstanbulTurkey
  3. 3.Acibadem University School of MedicineIstanbulTurkey
  4. 4.Department of NeurologyBakirkoy Research and Training HospitalIstanbulTurkey

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