Evaluation of Thoracoscopic Sympathectomy in Patients with Hyperhidrosis

Nikbakhsh, N; Naghshineh, A; Noorbaran, A

Evaluation of Thoracoscopic Sympathectomy in Patients with Hyperhidrosis

Document Type : Original Article

Authors

N Nikbakhsh ¹

A Naghshineh ²

A Noorbaran ²

¹ Associate Professor of Thoracic Surgery, Babol University of Medical Sciences, Cancer Research Center, Ayatollah Rouhani Hospital, Tehran, Iran

² Assistant Professor, Department of General Surgery, Babol University of Medical Sciences, Cancer Research Center, Ayatollah Rouhani Hospital

Abstract

Introduction & Objective: One of the efficient and available ways to treat the hyperhidrosis is thoracic sympathectomy. Our goal of this study was to evaluate the success rate of this method of therapy in patients with hyperhidrosis. Materials & Methods: This cross-sectional study enrolled all patients with initial hyperhidrosis in Babol Medical Sciences hospitals, between the years 2003-2015 whom have been hospitalized and treated by surgery. Eventually the patient entered the study were 51. The data analyzed by SPSS V. 20 and using statistical test of Chi-Square, T-Test analysis. Results: Of the 51 patients, 47 patients (92.1%) had no complications after surgery, 44 patients (86.2%) had complete response after surgery. There was no significant relation between age and success rate (P = 0.22). Between age of onset and thoracoscopic sympathectomy success rate there was no significant correlations (P = 0.54). There was no significant relation between job of patients and the success rate (P = 0.34). The findings indicate that the final result of sympathectomy surgery is in close relation with the level of sympathectomy (P = 0.01). Conclusions: Sympathectomy is a safe and effective treatment for patients with hyperhidrosis.

Keywords

Thoracic Sympathectomy

Hyperhidrosis

Surgery

1. Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 2004; 51: 274.

2. Moran KT, Brady MP. Surgical management of primary hyperhidrosis. Br J Surg 1991; 78: 279.

3. Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol 2004; 51: 241.

4. Walling HW. Primary hyperhidrosis increases the risk of cutaneous infection: a case-control study of 387 patients. J Am Acad Dermatol 2009; 61: 242.

5. Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg 1977; 186: 34.

6. Leung AK, Chan PY, Choi MC. Hyperhidrosis. Int J Dermatol 1999; 38: 561.

7. Ro KM, Cantor RM, Lange KL, Ahn SS. Palmar hyperhidrosis: evidence of genetic transmission. J Vasc Surg 2002; 35: 382.

8. Scrivener Y, Cribier B. [Morphology of sweat glands]. Morphologie 2002; 86:5.

9. Lonsdale-Eccles A, Leonard N, Lawrence C. Axillary hyperhidrosis: eccrine or apocrine? Clin Exp Dermatol 2003; 28: 2.

10. Sato K, Kang WH, Saga K, Sato KT. Biology of sweat glands and their disorders. I. Normal sweat gland function. J Am Acad Dermatol 1989; 20:537.

11. Van den Brande P, Vijgen J, Demedts M. Clinical spectrum of pulmonary tuberculosis in older patients: comparison with younger patients. J Gerontol 1991; 46: M204.

12. Bollinger RC, Brookmeyer RS, Mehendale SM, et al. Risk factors and clinical presentation of acute primary HIV infection in India. JAMA 1997; 278: 2085.

13. Scholes KT, Crow KD, Ellis JP, et al. Axillary hyperhidrosis treated with alcoholic solution of aluminium chloride hexahydrate. Br Med J 1978; 2: 84.

14. Goh CL. Aluminum chloride hexahydrate versus palmar hyperhidrosis. Evaporimeter assessment. Int J Dermatol 1990; 29: 368.

15. Hölzle E, Braun-Falco O. Structural changes in axillary eccrine glands following long-term treatment with aluminium chloride hexahydrate solution. Br J Dermatol 1984; 110: 399.

16. Stolman LP. Treatment of hyperhidrosis. Dermatol Clin 1998; 16: 863.

17. Kim WO, Kil HK, Yoon KB, Yoon DM. Topical glycopyrrolate for patients with facial hyperhidrosis. Br J Dermatol 2008; 158: 1094.

18. Kuritzky A, Hering R, Goldhammer G, Bechar M. Clonidine treatment in paroxysmal localized hyperhidrosis. Arch Neurol 1984; 41: 1210.

19. Torch EM. Remission of facial and scalp hyperhidrosis with clonidine hydrochloride and topical aluminum chloride. South Med J 2000; 93: 68.

20. Reinauer S, Neusser A, Schauf G, Hölzle E. Iontophoresis with alternating current and direct current offset (AC/DC iontophoresis): a new approach for the treatment of hyperhidrosis. Br J Dermatol 1993; 129: 166.

21. Dahl JC, Glent-Madsen L. Treatment of hyperhidrosis manuum by tap water iontophoresis. Acta Derm Venereol 1989; 69: 346.

22. Hallett M. One man's poison-clinical applications of botulinum toxin. N Engl J Med 1999; 341: 118.

23. Pasricha PJ, Ravich WJ, Hendrix TR, et al. Intrasphincteric botulinum toxin for the treatment of achalasia. N Engl J Med 1995; 332: 774.

24. Heckmann M, Ceballos-Baumann AO, Plewig G, Hyperhidrosis Study Group. Botulinum toxin A for axillary hyperhidrosis (excessive sweating). N Engl J Med 2001; 344: 488.

25. Solomon BA, Hayman R. Botulinum toxin type A therapy for palmar and digital hyperhidrosis. J Am Acad Dermatol 2000; 42: 1026.

26. Kontochristopoulos G, Gregoriou S, Zakopoulou N, Rigopoulos D. Cryoanalgesia with dichlorotetrafluoroethane spray versus ice packs in patients treated with botulinum toxin-a for palmar hyperhidrosis: Self-controlled study. Dermatol Surg 2006; 32: 873.

27. Smith KC, Comite SL, Balasubramanian S, et al. Vibration anesthesia: a noninvasive method of reducing discomfort prior to dermatologic procedures. Dermatol Online J 2004; 10: 1.

28. Peja M, Madácsy L, Kassay L, Bognár M. Metabolic relations of serum lipids and lipoproteins in diabetic children. Acta Paediatr Hung 1983; 24: 217.

29. Naumann M, Bergmann I, Hofmann U, et al. Botulinum toxin for focal hyperhidrosis: technical considerations and improvements in application. Br J Dermatol 1998; 139: 1123.

30. Benohanian A. What stands in the way of treating palmar hyperhidrosis as effectively as axillary hyperhidrosis with botulinum toxin type A. Dermatol Online J 2009; 15:12.

31. Bechara FG, Gambichler T, Bader A, et al. Assessment of quality of life in patients with primary axillary hyperhidrosis before and after
suction-curettage. J Am Acad Dermatol 2007; 57: 207.

32. Eisenach JH, Atkinson JL, Fealey RD. Hyperhidrosis: evolving therapies for a
well-established phenomenon. Mayo Clin Proc 2005; 80: 657.

33. Drott C, Göthberg G, Claes G. Endoscopic transthoracic sympathectomy: an efficient and safe method for the treatment of hyperhidrosis. J Am Acad Dermatol 1995; 33: 78.

34. 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.

35. Hong HC, Lupin M, O'Shaughnessy KF. Clinical evaluation of a microwave device for treating axillary hyperhidrosis. Dermatol Surg 2012; 38: 728.

36. Johnson JE, O'Shaughnessy KF, Kim S. Microwave thermolysis of sweat glands. Lasers Surg Med 2012; 44: 20.

37. Glaser DA, Coleman WP 3^rd, Fan LK, et al. A randomized, blinded clinical evaluation of a novel microwave device for treating axillary hyperhidrosis: the dermatologic reduction in underarm perspiration study. Dermatol Surg 2012; 38: 185.

38. Beatriz Isla-Tejera, et la. Economic Evaluation of Botulinum Toxin VersusThoracic Sympathectomy for Palmar Hyperhidrosis. 2013; 3: 63-72.

39. Murat Öncel- Guven Sadi Sunam, et la. Bilateral thoracoscopic sympathectomy for primary hyperhydrosis: a review of 335 cases. Cardiovascular Journal of Africa 2013; 24(3).

40. Paulo César Buffara Boscardim, et la. Thoracic sympathectomy at the level of the fourth and fifth ribs for the treatment of axillary hyperhidrosis. J Bras Pneumol. 2011; 37(1): 6-12.

41. Nelson Wolosker, et al. Objective evaluation of plantar hyperhidrosis after sympathectomy. Clinics 2013; 68(3): 311-315.

42. Joao Batista Baroncello, et la. Evaluation of quality of life before and after videothoracoscopic sympathectomy for primary hyperhidrosis. Col. Bras. Cir. 2014; 41(5): 325-330.

43. Haydeh Ghaninejad, Morteza Heidari. Botulinum toxin A (BTX-A) for treatment of palmar hyperhidrosis. Arch Iran Med 2001; 4 (3): 127-129.

44. Salmanpour et al. Treatment of axillary hyperhidrosis by botulinum toxin A (BTX-A). Journal of skin dis; 4 (2).