JOSE RIBAS MILANEZ DE CAMPOS

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Lattes
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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica, Hospital das Clínicas, Faculdade de Medicina

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Assunto: axillary hyperhidrosis ×

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Agora exibindo 1 - 10 de 21
  • article 5 Citação(ões) na Scopus
    Analysis of the Results of Videotoracoscopic Sympathectomy in the Treatment of Hyperhidrosis in Patients 40 Years or Older
    (2020) FAUSTINO, Carolina B.; CAMPOS, Jose Ribas Milanez de; KAUFFMAN, Paulo; LEIDERMAN, Dafne Diamante; TEDDE, Miguel; CUCATO, Gabriel; FERNANDES, Paulo P.; LEAO, Pedro P.; WOLOSKER, Nelson
    Background: Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (video-assisted thoracoscopic sympathectomy [VATS]) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of patients aged 40 years or older compared with those of young adult patients (19-40 years). Methods: We retrospectively analyzed 2,431 HH patients who underwent bilateral VATS and divided the patients into the following groups: a group younger than 40 years old (1,760 patients) and a group 40 years and older (142 patients). Variables included quality of life before surgery, improvement in quality of life after surgery, clinical improvement in sweating, the presence of severe compensatory hyperhidrosis (CH), and general satisfaction at 1 month after surgery. Results: We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the 2 groups of patients. More than 90% of the patients in this series had great clinical improvement in the main HH site, with no significant difference between the 2 groups. Severe CH occurred in 23.8% of the patients in this series, with no significant difference between the 2 groups. Conclusions: Patients 40 years of age or older benefit just as much as younger patients from VATS performed to treat primary HH, presenting excellent significant surgical results.
  • article 17 Citação(ões) na Scopus
    Long-term results of the use of oxybutynin for the treatment of plantar hyperhidrosis
    (2015) WOLOSKER, Nelson; TEIVELIS, Marcelo P.; KRUTMAN, Mariana; PAULA, Rafael P. de; KAUFFMAN, Paulo; CAMPOS, Jose R. M. de; PUECH-LEAO, Pedro
    BackgroundPlantar hyperhidrosis is a common illness with significant impact on quality of life. Oxybutynin presents good short-term results, but longer follow-up results are lacking. We evaluated oxybutynin effectiveness in patients who were not surgically treated and who had at least sixmonths of follow-up. MethodsFrom September 2007 to September 2013, 85 consecutive patients were enrolled in our institutional protocol for the pharmacological-first treatment of primary plantar hyperhidrosis with oxybutynin. Eight patients were lost to follow-up, 15 patients have not yet been under treatment for sixmonths, and data were available for 39 patients (all female) treated for at least sixmonths. Data at the start of the protocol, sixweeks after beginning treatment, and at their final visit were analyzed. ResultsTwenty-three of the 77 patients (29.87%) did not improve after pharmacological therapy. From the 39 patients with more than sixmonths of follow-up (median 16.9months, range 9-71), 79.5% reported moderate/great improvement in excessive plantar sweating after sixweeks of treatment, and this rate increased to 84.7% in the last follow-up visit; 82.85% showed improvement in other sites presenting hyperhidrosis. Dry mouth was the most common side effect; 51.6% of patients reported it to be moderate/severe at the last visit. ConclusionIn patients with good initial response to oxybutynin, more than 82% presented moderate or great improvement in plantar and other sites' excessive sweating; dry mouth was the most common side effect but was tolerable and did not lead any patient to interrupt treatment.
  • article 43 Citação(ões) na Scopus
    Technical Difficulties and Complications of Sympathectomy in the Treatment of Hyperhidrosis: An Analysis of 1731 Cases
    (2013) ANDRADE FILHO, Laert Oliveira de; KUZNIEC, Sergio; WOLOSKER, Nelson; YAZBEK, Guilherme; KAUFFMAN, Paulo; CAMPOS, Jose Ribas Milanez de
    Background: The aim of this study was to ascertain the technical difficulties and complications of video-assisted thoracic sympathectomy (VTAS) in the treatment of hyperhidrosis in a large group of patients. Methods: Between October 1995 and February 2008, 1731 patients with palmar, axillary, or craniofacial hyperhidrosis, who were treated using bilateral VTAS, were studied. We assessed the technical difficulties, early and late complications, and the approaches that were used to resolve them. Results: Therapeutic success was achieved in 91% of the cases as evidenced by anhidrosis. The most common and severe technical difficulty during the procedure was pleural adhesions in 116 cases (6.7%); azygos lobes were seen in 7 patients (0.4%) and apical blebs in 3 patients (0.2%). The most frequent postoperative immediate complication was postoperative pain in 1685 (97.4%) patients; pneumothorax with chest drainage was seen in 60 cases (3.5%), neurologic disorders involving the upper limbs in 36 cases (2.1%), Homer's syndrome in 11 cases (0.9%), significant bleeding in 8 cases (0.4%), and 1 patient had extensive subcutaneous emphysema. The most frequent late complication was compensatory hyperhidrosis, which occurred in 1531 cases (88.4%). Although 27.2% of the patients reported severe compensatory hyperhidrosis, only 2.5% expressed regret for undergoing surgery. Gustatory sweating occurred in 334 patients (19.3%). No deaths occurred in this series. Conclusions: VTAS is safe and has shown good results. The major complication is compensatory hyperhidrosis and, when severe, the patient may express regret for undergoing surgery. Improvements in instrumentation, adequate training, and careful patient selection may help to reduce the number of drawbacks associated with VTAS.
  • article 9 Citação(ões) na Scopus
    Video-Assisted Thoracic Sympathectomy for Hyperhidrosis
    (2016) CAMPOS, Jose Ribas Milanez de; KAUFFMAN, Paulo; GOMES JR., Oswaldo; WOLOSKER, Nelson
    By the 1980s, endoscopy was in use by some groups in sympathetic denervation of the upper limbs with vascular indications. Low morbidity, cosmetic results, reduction in the incidence of Homer syndrome, and the shortened time in hospital made video-assisted thoracic sympathectomy (VATS) better accepted by those undergoing treatment for hyperhidrosis. Over the last 25 years, this surgical procedure has become routine in the treatment of hyperhidrosis, leading to a significant increase in the number of papers on the subject in the literature.
  • article 50 Citação(ões) na Scopus
    Efficacy and Quality of Life Outcomes of Oxybutynin for Treating Palmar Hyperhidrosis in Children Younger than 14 Years Old
    (2014) WOLOSKER, Nelson; SCHVARTSMAN, Claudio; KRUTMAN, Mariana; CAMPBELL, Taiz Pereira Dozono Almeida; KAUFFMAN, Paulo; CAMPOS, Jose Ribas M. de; PUECH-LEAO, Pedro
    The effects of oxybutynin for treating hyperhidrosis in children are still unknown. Therefore the aim of this study was to investigate the effects of oxybutynin on improving symptoms of hyperhidrosis and quality of life (QOL) in children with palmar hyperhidrosis (PH). Forty-five children ages 7-14 years with PH were evaluated 6 weeks after protocol treatment with oxybutynin. QOL was evaluated before and after treatment using a validated clinical questionnaire. More than 85% of the children with PH treated with oxybutynin experienced moderate or greater improvement in the level of sweating and 80% experienced improvement in QOL. Children who initially presented with very poor QOL were those who benefited most from oxybutynin therapy. Side effects occurred in 25 children (55.5%) and were mainly dry mouth. Only one patient had neurologic symptoms, which was reported as drowsiness. Oxybutynin is an effective treatment option for children with PH because it improves clinical symptoms and QOL. Further studies are required to determine the long-term outcomes of treatment with oxybutynin.
  • article 20 Citação(ões) na Scopus
    Long-Term Comparison of Video-Assisted Thoracic Sympathectomy and Clinical Observation for the Treatment of Palmar Hyperhidrosis in Children Younger Than 14
    (2012) NEVES, Samantha; UCHOA, Patricia C.; WOLOSKER, Nelson; MUNIA, Marco A.; KAUFFMAN, Paulo; CAMPOS, Jose Ribas M. de; PUECH-LEAO, Pedro
    The results of video-assisted thoracic sympathectomy (VATS)in children are unknown. To investigate the improvement in quality of life (QOL) of a group of 45 children who did and did not undergo VATS for the treatment of palmar hyperhidrosis (PH) 4 years after the initial evaluation. Forty-five children with PH were initially evaluated. Children were divided into two groups: 30 in the VATS group and 15 in the control group. We studied the evolution of PH, negative effect of hyperhidrosis on the QOL before the treatment, and improvement in QOL after treatment. Twenty-five patients (83.4%) in the VATS group experienced great improvement in PH, and five (16.6%) experienced partial improvement; 12 (80.0%) children from the control group had some type of improvement, and three (20.0%) had partial improvement. Two (13.3%) children in the control group and 23 (76.7%) in the VATS group had great improvement in QOL. For children with PH and poor QOL, VATS is better than no treatment. It produces better results with regard to sweating and greater improvement in QOL.
  • article 11 Citação(ões) na Scopus
    Videothoracoscopic Sympathectomy Results after Oxybutynin Chloride Treatment Failure
    (2017) LEMBRANCA, Lucas; WOLOSKER, Nelson; CAMPOS, Jose Ribas Milanez de; KAUFFMAN, Paulo; TEIVELIS, Marcelo Passos; PUECH-LEAO, Pedro
    Background: Videothoracoscopy sympathectomy (VATS) is the only definitive treatment for primary hyperhidrosis (HH). Since 2007, in our institution, patients with HH were initially treated with oxybutynin chloride to avoid VATS and reduce compensatory hyperhidrosis incidence with good results. The aim of this study was to analyze the surgical response of patients suffering from essential hyperhidrosis after failure of oxybutynin chloride treatment. Methods: This was an observational retrospective study that included 737 patients who were diagnosed with palmar or axillary hyperhidrosis and received VATS from January 2007 to January 2014. Patients were selected for 2 different groups: The post-oxybutynin surgery group consisted of 167 patients that were initially treated with oxybutynin chloride for 6 weeks and then received VATS after drug treatment failure. The primary surgery group consisted of a historic control group of 570 patients who were referred directly to surgical treatment. We evaluated the degree of improvement in symptoms 30 days after surgery and quality of life before and after the surgical treatment. Results: All patients showed poor or very poor quality of life before surgery. Most patients showed a response between moderate and high after surgical treatment. However, those in primary surgery group responded better (95.1% vs. 98.2%). In the quality of life after surgery, most of the patients reported improvement, and the primary surgery group had better improvement (92.2% vs. 95.1%). Conclusions: VATS showed good results in patients with palmar or axillary hyperhidrosis regarding surgical response and improvement on quality of life even when the previous oxybutynin chloride treatment failed.
  • article 5 Citação(ões) na Scopus
    Evaluation of patients who underwent resympathectomy for treatment of primary hyperhidrosis
    (2017) CAMPOS, Jose Ribas Milanez de; LEMBRANCA, Lucas; FUKUDA, Juliana Maria; KAUFFMAN, Paulo; TEIVELIS, Marcelo Passos; PUECH-LEAO, Pedro; WOLOSKER, Nelson
    OBJECTIVES: Video thoracoscopic sympathectomy is the recommended surgical treatment for primary hyperhidrosis and has a high success rate. Despite this high success rate, some patients are unresponsive and eventually need a resympathectomy. Few studies have previously analysed exclusively the results of these resympathectomies in patients with primary hyperhidrosis. None of the studies have objectively evaluated the degree of response to surgery or the improvement in quality of life after resympathectomies. METHODS: This is a retrospective study, evaluating 15 patients from an initial group of 2300 patients who underwent resympathectomy after failure of the primary surgical treatment. We evaluated sympathectomy levels of resection, technical difficulties, surgical complications preoperative quality of life, response to treatment and quality-of-life improvement 30 days after each surgery. RESULTS: Regarding gender, 11 (73.3%) patients were women. The average age was 23.2 with SD of 5.17 years, and the mean body mass index was 20.9 (SD 2.12). Ten patients had major complaints about their hands (66%) and 5 (33%) patients about their forearms. A high degree of response to sympathectomy occurred in 73% of patients. In 11 of these patients, the improvement in quality of life was considered high, 3 showed a mild improvement and 1 did not improve. No major complications occurred; the presence of adhesions was reported in 11 patients and pleural drainage was necessary in 4 patients. CONCLUSIONS: Resympathectomy is an effective procedure, and it improves the quality of life in patients with primary hyperhidrosis who failed after the first surgery.
  • article 24 Citação(ões) na Scopus
    Long-term results of oxybutynin use in treating facial hyperhidrosis
    (2014) WOLOSKER, Nelson; KRUTMAN, Mariana; KAUFFMAN, Paulo; PUECH-LEAO, Pedro; TEIVELIS, Marcelo Passos; CAMPBELL, Taiz Pereira Dozono de Almeida; CAMPOS, Jose Ribas de
    BACKGROUND: Facial hyperhidrosis can lead to serious emotional distress. Video-assisted thoracic sympathectomy resolves symptoms effectively, though it may be associated with compensatory hyperhidrosis, which may be more common in patients undergoing resection of the second thoracic ganglion. Oxybutynin has been used as a pharmacological approach to facial hyperhidrosis but the long-term results of this treatment are unclear. OBJECTIVE: To evaluate the use of low oxybutynin doses in facial hyperhidrosis patients for at least six months. METHODS: 61 patients were monitored for over six months and assessed according to the following variables: impact of hyperhidrosis on quality of life (QOL) before treatment and after six weeks, evolution of facial hyperhidrosis after six weeks and at the last consultation, complaints of dry mouth after six weeks and on last return visit, and improvement at other hyperhidrosis sites. RESULTS: Patients were monitored for 6 to 61 months (median=17 months). Thirty-six (59%) were female. Age ranged from 17-74 (median: 45). Pre-treatment QOL was poor/very poor in 96.72%. After six weeks, 100% of patients improved QOL. Comparing results after six weeks and on the last visit, 91.8% of patients maintained the same category of improvement in facial hyperhidrosis, 3.3% worsened and 4.9% improved. Dry mouth complaints were common but not consistent throughout treatment. More than 90% of patients presented moderate/great improvement at other hyperhidrosis sites. CONCLUSION: Patients who had a good initial response to treatment maintained a good response long-term, did not display tachiphylaxis and experienced improvement on other hyperhidrosis sites.
  • article 33 Citação(ões) na Scopus
    Long-term results of oxybutynin treatment for palmar hyperhidrosis
    (2014) WOLOSKER, Nelson; TEIVELIS, Marcelo Passos; KRUTMAN, Mariana; PAULA, Rafael P. de; CAMPOS, Jose R. M. de; KAUFFMAN, Paulo; PUECH-LEAO, Pedro
    Palmar hyperhidrosis (PH) is a common illness that significantly impacts Quality of Life (QOL). Oxybutynin offers excellent short-term results, but long-term follow-up results are limited. We evaluated its effectiveness in a large group of patients who did not have surgery and who had at least 6 months of follow-up. Between September 2007 and September 2013, 570 consecutive patients were enrolled in our institutional protocol regarding the ""pharmacological-first"" treatment of primary PH with oxybutynin. Fifty-nine were lost to follow-up, and the data were available for 511 patients treated for at least 6 weeks. Data recorded at the start of the protocol, 6 weeks after beginning treatment, and during patients' final visits were analyzed. 112 patients (21.9 %) did not improve and were referred for surgery (sympathectomy). Eight (1.56 %) developed significant side effects (e.g., dry mouth) and discontinued therapy. Thirty (5.9 %) preferred surgery over pharmacological treatment. 111 have not yet received treatment for 6 months. The 246 patients with more than 6 months of follow-up (median 16 months, range 6-72) were analyzed, as follows: 90.2 % experienced moderate or great improvement in their PH; 90.34 % experienced improvement at other sites of hyperhidrosis following a median of 16 months. Among patients with good initial responses to oxybutynin, more than 90 % experienced moderate or great improvement in their palmar sweating, as well as in their hyperhidrosis in other sites, after 6 months. The results were particularly favorable in those patients with BMI < 25 kg/m(2), and in those who noted an improved QOL after 6 weeks.