Objective evaluation of plantar hyperhidrosis after sympathectomy

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author WOLOSKER, Nelson FMUSP-HC
ISHY, Augusto
YAZBEK, Guilherme FMUSP-HC
CAMPOS, Jose Ribas Milanez de FMUSP-HC
KAUFFMAN, Paulo FMUSP-HC
PUECH-LEAO, Pedro FMUSP-HC
JATENE, Fabio Biscegli FMUSP-HC
dc.date.issued 2013
dc.identifier.citation CLINICS, v.68, n.3, p.311-315, 2013
dc.identifier.issn 1807-5932
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/1684
dc.description.abstract OBJECTIVE: The aim of the present study was to prospectively, randomly, blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter). METHODS: From February 2007 to May 2009, 40 consecutive patients with combined palmar hyperhidrosis and plantar hyperhidrosis underwent video-assisted thoracic sympathectomy at the T3 or T4 ganglion level (15 women and 25 men, with a mean age of 25 years). RESULTS: Immediately after the operation and during the one-year follow-up, all of the patients were free from palmar hyperhidrosis episodes. Compensatory hyperhidrosis of varying degrees was observed in 35 (87.5%) patients after one year. Only two (2.5%) patients suffered from severe compensatory hyperhidrosis. There was a large initial improvement in plantar hyperhidrosis in 46.25% of the cases, followed by a progressive regression of that improvement, such that only 30% continued to show this improvement after one year. The proportion of patients whose condition worsened increased progressively (from 21.25% to 47.50%), and the proportion of stable patients decreased (32.5% to 22.50%). This was not related to resection level; however, a lower intensity of plantar hyperhidrosis prior to sympathectomy correlated with worse evolution. CONCLUSION: Patients with palmar hyperhidrosis and plantar hyperhidrosis who underwent video-assisted thoracic sympathectomy to treat their palmar hyperhidrosis exhibited good initial improvement in plantar hyperhidrosis, which then decreased to lesser degrees of improvement over a one-year period following the surgery. For this reason, video-assisted thoracic sympathectomy should not be performed when only plantar hyperhidrosis is present.
dc.language.iso eng
dc.publisher HOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartof Clinics
dc.rights openAccess
dc.subject Sweating; Hyperhidrosis; Video-Assisted Thoracic Sympathectomy; Autonomic Ganglia
dc.subject.other assisted thoracoscopic sympathectomy; endoscopic thoracic sympathectomy; isolated axillary hyperhidrosis; quality-of-life; palmar hyperhidrosis; palmoplantar hyperhidrosis; t3 level; t4; sweat; t2
dc.title Objective evaluation of plantar hyperhidrosis after sympathectomy
dc.type article
dc.rights.holder Copyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.description.group LIM/61
dc.description.group LIM/28
dc.description.group LIM/02
dc.description.group LIM/11
dc.identifier.doi 10.6061/clinics/2013(03)OA05
dc.identifier.pmid 23644849
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author WOLOSKER, Nelson:FM:MCG
hcfmusp.author YAZBEK, Guilherme:FM:
hcfmusp.author CAMPOS, Jose Ribas Milanez de:HC:ICHC
hcfmusp.author KAUFFMAN, Paulo:FM:MCG
hcfmusp.author PUECH-LEAO, Pedro:FM:MCG
hcfmusp.author JATENE, Fabio Biscegli:FM:MCP
hcfmusp.author.external · ISHY, Augusto:Univ Sao Paulo, Fac Med, Hosp Clin, Div Thorac Surg, Sao Paulo, Brazil
hcfmusp.origem.id 2-s2.0-84878154545
hcfmusp.origem.id WOS:000320000800006
hcfmusp.origem.id SCIELO:S1807-59322013000300006
hcfmusp.publisher.city SAO PAULO
hcfmusp.publisher.country BRAZIL
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dc.description.index MEDLINE
hcfmusp.citation.scopus 5
hcfmusp.citation.wos 7
hcfmusp.affiliation.country Brasil


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