Clinical Autonomic Research

, Volume 15, Issue 2, pp 116–120 | Cite as

The body mass index and level of resection

Predictive factors for compensatory sweating after sympathectomy
  • José Ribas Milanez de Campos
  • Nelson Wolosker
  • Flavio Roberto Takeda
  • Paulo Kauffman
  • Sergio Kuzniec
  • Fábio Biscegli Jatene
  • Sérgio Almeida de Oliveira



Compensatory sweating (CS) is the most common adverse event and the main cause of dissatisfaction among patients undergoing a VATS sympathectomy for the treatment of primary hyperhidrosis. It has been described that obese individuals experience more sweating than thinner ones. The aim of this study is to identify the Body Mass Index (BMI) and the level of resection as predictive factors for CS and its relation to levels of patient satisfaction following the procedure.


From October 1998 to June 2003, 102 patients undergoing VATS sympathectomies (51 for palmar hyperhidrosis, PH, and 51 for axillary hyperhidrosis, AH) were prospectively surveyed. They were divided into three groups according to their BMI: Group I was composed of 19 patients with BMI<20 (9 patients with PH and 10 with AH); Group II was composed of 52 patients with 20 ≤BMI<25 (25 with PH and 27 with AH); and Group III was composed of 31 patients with BMI ≥ 25 (17 with PH and 14 with AH). Each procedure was simultaneously and bilaterally performed under general anesthesia using two 5.5mm trocars and a 30° optic system.


Patients treated for PH (resection of T2-T3) had more severe CS than those with AH (resection of T3-T4) (p=0.007) and the greater the BMI, the greater the severity of the CS (p<0.001). No statistically significant difference was found between the BMI bands in relation to the degree of satisfaction (p=0.644), nor when we compared the degree of satisfaction to the degree of CS (p=0.316).


The greater the BMI, the more severe the CS, but this did not correlate with the patients’ level of satisfaction. Avoiding the resection of T2 sympathetic ganglia is also important in reducing the intensity of CS.

Key words

body mass index compensatory sweating sympathectomy quality of life subjective rating scale 


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  1. 1.
    Alric P, Branchereau P, Berthet JP, Leger P, Mary H, Mary-Ane C (2002) Video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis: results in 102 cases. Ann Vasc Surg 16(6):708–713Google Scholar
  2. 2.
    Bray GL (1985) Obesity definition, diagnosis and disadvantages. Med J Aust 142:52–58Google Scholar
  3. 3.
    De Campos JR, Kauffman P, Werebe EC, Andrade Filho LO, Kusniek S, Wolosker N, Jatene FB (2003) Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg 76(3):886–891Google Scholar
  4. 4.
    Doblas M, Gutierrez R, Fontcuberta J, Orgaz A, Lopez P, Criado E (2003) Thoracodorsal sympathectomy for severe hyperhydrosis: posterior bilateral versus unilateral staged sympathectomy. Ann Vasc Surg 17(1):97–102Google Scholar
  5. 5.
    Drott C, Gothberg G, Claes G (1995) Endoscopic transthoracic sympathectomy: an efficient and safe method for the treatment of hyperhidrosis. J Am Acad Dermatol 33(1):78–81Google Scholar
  6. 6.
    Ferro-Luzzi A, Sette S, Franklin M, James WPT (1992) A simplified approach to assessing adult chronic energy deficiency. Eur J Clin Nut 46:173–186Google Scholar
  7. 7.
    Gossot D, Toledo L, Fritsch S, Celerier M (1997) Thoracoscopic sympathectomy for upper limb hyperhidrosis: looking for the right operation. Ann Thorac Surg 64(4):975–978Google Scholar
  8. 8.
    James WPT, Ferro-Luzzi A, Waterlow JC (1988) Definition of chronic energy deficiency in adults. Report of working party of the International Dietary Energy Consultative Group. Eur J Clin Nut 42:961–981Google Scholar
  9. 9.
    Kenchaiah S, Evans JC, Levy D, Wilson, PWF, Benjamim EJ, Larson MG, Kannel WB, Vasan RS (2002) Obesity and the risk of heart failure. N Engl J Med 347(5):305–313Google Scholar
  10. 10.
    Lai YT, Yang LH, Chio CC, Chen HH (1997) Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. Neurosurgery 41(1):110–115Google Scholar
  11. 11.
    Lecerf JM, Reitz C, De Chasteigner A (2003) Evaluation of discomfort and complications in a population of 18,102 overweight or obese patients. Presse Med 32(15):689–695Google Scholar
  12. 12.
    Leseche G, Castier Y, Thabut G, Petit MD, Combes M, Cerceau O, Besnard M (2003) Endoscopic transthoracic sympathectomy for upper limb hyperhidrosis: limited sympathectomy does not reduce postoperative compensatory sweating. J Vasc Surg 37(1):124–128Google Scholar
  13. 13.
    Lin CC, Wu HH (2001) Lin-Telaranta classification: the importance of different procedures for different indications in sympathetic surgery. Ann Chir Gynaecol 90(3):161–166Google Scholar
  14. 14.
    Moran KT, Brady MP (1991) Surgical management of primary hyperhidrosis. Br J Surg 78(3):279–283Google Scholar
  15. 15.
    O’Riordain DS, Maher M, Waldron DJ, O’Donovan B, Brady MP (1993) Limiting the anatomic extent of upper thoracic sympathectomy for primary palmar hyperhidrosis. Surg Gynecol Obstet 176(2):151–154Google Scholar
  16. 16.
    Pichard C, Kyle UG (1998) Body composition measurements during wasting diseases. Curr Opin Clin Nutr Metab Care 1(4):357–361Google Scholar
  17. 17.
    Pietrobelli AAB, Wang ZA, Heymsfield SBA (1998) Techniques used in measuring human body composition. Curr Opin Clin Nutr Metab Care 1(5):439–448Google Scholar
  18. 18.
    Shachor D, Jedeikin R, Olsfanger D, Bendahan J, Sivak G, Freund U (1994) Endoscopic transthoracic sympathectomy in the treatment of primary hyperhidrosis. A review of 290 sympathectomies. Arch Surg 129(3):241–244Google Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • José Ribas Milanez de Campos
    • 1
  • Nelson Wolosker
    • 2
  • Flavio Roberto Takeda
    • 3
    • 4
  • Paulo Kauffman
    • 2
  • Sergio Kuzniec
    • 2
  • Fábio Biscegli Jatene
    • 3
  • Sérgio Almeida de Oliveira
    • 5
  1. 1.Dept. of Thoracic SurgeryHospital das Clínicas Heart Institute—Incor University of São Paulo Medical SchoolSão PauloBrazil
  2. 2.Dept. of Vascular SurgeryHospital das Clínicas University of São Paulo Medical SchoolSão PauloBrazil
  3. 3.Dept. of Thoracic SurgeryHospital das Clínicas Heart Institute—Incor University of São Paulo Medical SchoolSão PauloBrazil
  4. 4.R: Joaquim Antunes, 865 apto:111São Paulo05415.012—Brazil
  5. 5.Dept. of Cardiovascular and Thoracic SurgeryHospital das Clínicas Heart Institute—Incor University of São Paulo Medical SchoolSão PauloBrazil

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