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Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Immediate Results and Postoperative Quality of Life
J. Loscertales, A. Arroyo Tristán, M. Congregado Loscertales
, R. Jiménez Merchán, J.C. Girón Arjona, C. Arenas Linares, J. Ayarra Jarné
Corresponding author
jloscert@us.es
Correspondence: Dr. J. Loscertales. Servicio de Cirugía General y Torácica. Hospital Universitario Virgen Macarena. Avda. Dr. Fedriani, 3. 41074 Sevilla. España
Correspondence: Dr. J. Loscertales. Servicio de Cirugía General y Torácica. Hospital Universitario Virgen Macarena. Avda. Dr. Fedriani, 3. 41074 Sevilla. España
Servicio de Cirugía General y Torácica, Hospital Universitario Virgen Macarena, Seville, Spain
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"apellidos" => "Arroyo Tristán" ] 2 => array:5 [ "preGrado" => "Dr." "nombre" => "M." "apellidos" => "Congregado Loscertales" "email" => array:1 [ 0 => "jloscert@us.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Jiménez Merchán" ] 4 => array:2 [ "nombre" => "J.C." "apellidos" => "Girón Arjona" ] 5 => array:2 [ "nombre" => "C." "apellidos" => "Arenas Linares" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Ayarra Jarné" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cirugía General y Torácica, Hospital Universitario Virgen Macarena, Seville, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Loscertales. Servicio de Cirugía General y Torácica. Hospital Universitario Virgen Macarena. Avda. Dr. Fedriani, 3. 41074 Sevilla. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-05-26" "fechaAceptado" => "2003-07-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec153266" "palabras" => array:4 [ 0 => "Hyperhidrosis" 1 => "Video-assisted thoracoscopic sympathectomy" 2 => "VATS" 3 => "Postoperative quality of life" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153267" "palabras" => array:3 [ 0 => "Hiperhidrosis" 1 => "Simpatectomía torácica videotoracoscópica" 2 => "Calidad de vida postoperatoria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Primary palmar hyperhidrosis is a socially and occupationally debilitating disorder characterized by excessive sweating. The purpose of this study was to evaluate the results, complications, and degree of satisfaction among patients who underwent video-assisted bilateral thoracoscopic sympathectomy of the second and third ganglia (T2-T3) to treat primary palmar hyperhidrosis at the Department of General and Thoracic Surgery of the Hospital Universitario Virgen Macarena in Seville, Spain.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p class="elsevierStyleSimplePara elsevierViewall">A study of 226 thoracoscopic sympathectomies was undertaken based on case histories and a prospective pre- and postoperative questionnaire survey. The sample was composed of 113 patients (47 males and 66 females), ranging in age from 14 to 50 years, with primary palmar and axillary hyperhidrosis, in some cases severe. Bilateral video-assisted thoracoscopic T2-T3 sympathectomy was performed under general anesthesia in all cases. Follow up included a questionnaire on pre- and postoperative quality of life and degree of satisfaction. Descriptive statistics on the surgical procedure, quality of life, and postoperative changes were compiled and frequency analyzed. A nonparametric Wilcoxon test for paired variables was performed to contrast significant differences between pre- and postoperative quality of life related to hyperhidrosis and its complications.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The therapeutic success rate was 100%. Complications were seen in 14.2% of the cases and included hemothorax in two, hemopneumothorax in three, pleural hemorrhage in two, and minimal apical airspace in nine. Of the 106 patients who were monitored over a period of 6 to 12 months through follow-up interviews and questionnaires, 67% developed compensatory sweating, 95% reported improvement in quality of life, and 4% experienced no change in quality of life, mainly because of the emergence of compensatory sweating. Of the patients interviewed, 97.2% said that they would undergo the operation again.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p class="elsevierStyleSimplePara elsevierViewall">Video-assisted thoracoscopic sympathectomy for the treatment of primary palmar hyperhidrosis is effective, with low rates of morbidity and no mortality. Despite the appearance of postoperative changes such as compensatory sweating, patient satisfaction with the procedure is high and their quality of life improves.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La hiperhidrosis palmar primaria localizada es un trastorno en la producción del sudor que resulta social y laboralmente incapacitante. El propósito de este estudio es evaluar los resultados, complicaciones y grado de satisfacción de los pacientes con hiperhidrosis palmar primaria tratados con simpatectomía videotoracoscópica T2-T3 bilateral en el Servicio de Cirugía General y Torácica del Hospital Universitario Virgen Macarena de Sevilla.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio clínico prospectivo histórico de 226 simpatectomías torácicas. La muestra la componen 113 pacientes (47 varones y 66 mujeres) de 14 a 50 años años de edad con hiperhidrosis palmar y axilar primaria, en algunos severa. A todos ellos se les intervino bajo anestesia general practicándoseles simpatectomía videotoracoscópica T2-T3 bilateral. Se presenta un seguimiento mediante cuestionario en relación con la calidad de vida y grado de satisfacción pre y postoperatoria. Se han efectuado análisis de frecuencia y descriptivos de los datos obtenidos sobre la técnica quirúrgica, calidad de vida y cambios posteriores a la cirugía y una prueba no paramétrica de Wilcoxon para dos variables relacionadas para contrastar diferencias significativas entre la calidad de vida pre y postoperatoria con relación a la hiperhidrosis y sus complicaciones.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El porcentaje de éxito terapéutico ha sido del 100%. La tasa de complicaciones del procedimiento fue del 14,2% e incluyó hemotórax en dos pacientes, hemoneumotórax en tres, derrame pleural en dos y mínima cámara aérea apical en 9. De los 106 pacientes a los que se les realizó seguimiento entre 6 y 12 meses mediante entrevista y cuestionario, un 67% de ellos desarrollaron sudación compensatoria. Un 95% de estos pacientes refirió mejoría de su calidad de vida, y un 4% no experimentó ningún cam bio en ella, sobre todo al considerar la aparición de la sudación compensatoria. El 97,2% de los pacientes entrevistados respondieron afirmativamente a la cuestión de si se volverían a operar.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p class="elsevierStyleSimplePara elsevierViewall">La simpatectomía videotoracoscópica es un método efectivo para el tratamiento de la hiperhidrosis palmar primaria con bajas tasas de morbilidad y nulas de mortalidad. A pesar de la aparición de cambios posteriores como la sudación compensatoria, presenta una alta tasa de satisfacción y mejora de la calidad de vida de los pacientes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thoracic thoracoscopic sympathectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W Scout" 1 => "M Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "General Thoracic Surgery" "fecha" => "2000" "volumen" => "43" "paginaInicial" => "579" "paginaFinal" => "582" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of primary 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 29 | 17 | 46 |
| 2024 September | 39 | 13 | 52 |
| 2024 August | 46 | 42 | 88 |
| 2024 July | 32 | 21 | 53 |
| 2024 June | 29 | 21 | 50 |
| 2024 May | 34 | 20 | 54 |
| 2024 April | 23 | 27 | 50 |
| 2024 March | 30 | 17 | 47 |
| 2024 February | 23 | 16 | 39 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 20 | 18 | 38 |
| 2023 January | 20 | 32 | 52 |
| 2022 December | 22 | 27 | 49 |
| 2022 November | 31 | 25 | 56 |
| 2022 October | 24 | 36 | 60 |
| 2022 September | 16 | 26 | 42 |
| 2022 August | 24 | 51 | 75 |
| 2022 July | 28 | 52 | 80 |
| 2022 June | 22 | 30 | 52 |
| 2022 May | 35 | 36 | 71 |
| 2022 April | 35 | 33 | 68 |
| 2022 March | 20 | 35 | 55 |
| 2022 February | 38 | 51 | 89 |
| 2022 January | 35 | 32 | 67 |
| 2021 December | 35 | 45 | 80 |
| 2021 November | 42 | 47 | 89 |
| 2021 October | 65 | 35 | 100 |
| 2021 September | 21 | 55 | 76 |
| 2021 August | 32 | 39 | 71 |
| 2021 July | 23 | 29 | 52 |
| 2021 June | 39 | 42 | 81 |
| 2021 May | 20 | 36 | 56 |
| 2021 April | 50 | 65 | 115 |
| 2021 March | 59 | 24 | 83 |
| 2021 February | 21 | 19 | 40 |
| 2021 January | 21 | 9 | 30 |
| 2020 December | 17 | 11 | 28 |
| 2020 November | 17 | 13 | 30 |
| 2020 October | 11 | 4 | 15 |
| 2020 September | 13 | 11 | 24 |
| 2020 August | 14 | 12 | 26 |
| 2020 July | 16 | 15 | 31 |
| 2020 June | 15 | 5 | 20 |
| 2020 May | 12 | 15 | 27 |
| 2020 April | 19 | 14 | 33 |
| 2020 March | 15 | 20 | 35 |
| 2020 February | 13 | 15 | 28 |
| 2020 January | 13 | 14 | 27 |
| 2019 December | 15 | 18 | 33 |
| 2019 November | 8 | 17 | 25 |
| 2019 October | 11 | 12 | 23 |
| 2019 September | 6 | 8 | 14 |
| 2019 August | 11 | 11 | 22 |
| 2019 July | 11 | 15 | 26 |
| 2019 June | 6 | 8 | 14 |
| 2019 May | 11 | 5 | 16 |
| 2019 April | 17 | 14 | 31 |
| 2019 March | 8 | 32 | 40 |
| 2019 February | 13 | 11 | 24 |
| 2019 January | 4 | 10 | 14 |
| 2018 December | 4 | 13 | 17 |
| 2018 November | 16 | 17 | 33 |
| 2018 October | 18 | 18 | 36 |
| 2018 September | 10 | 8 | 18 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 4 | 9 | 13 |
| 2018 March | 2 | 1 | 3 |
| 2018 February | 7 | 6 | 13 |
| 2018 January | 3 | 12 | 15 |
| 2017 December | 4 | 13 | 17 |
| 2017 November | 2 | 8 | 10 |
| 2017 October | 10 | 10 | 20 |
| 2017 September | 6 | 15 | 21 |
| 2017 August | 4 | 7 | 11 |
| 2017 July | 5 | 8 | 13 |
| 2017 June | 7 | 22 | 29 |
| 2017 May | 6 | 16 | 22 |
| 2017 April | 2 | 8 | 10 |
| 2017 March | 5 | 7 | 12 |
| 2017 February | 3 | 11 | 14 |
| 2017 January | 3 | 8 | 11 |
| 2016 December | 8 | 7 | 15 |
| 2016 November | 10 | 8 | 18 |
| 2016 October | 7 | 11 | 18 |
| 2016 September | 7 | 10 | 17 |
| 2016 August | 12 | 3 | 15 |
| 2016 July | 4 | 0 | 4 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 39 | 1 | 40 |
| 2015 September | 57 | 16 | 73 |
| 2015 August | 48 | 19 | 67 |
| 2015 July | 48 | 7 | 55 |
| 2015 June | 33 | 12 | 45 |
| 2015 May | 56 | 20 | 76 |
| 2015 April | 39 | 7 | 46 |
| 2015 March | 57 | 11 | 68 |
| 2015 February | 35 | 3 | 38 |
| 2015 January | 43 | 6 | 49 |
| 2014 December | 33 | 8 | 41 |
| 2014 November | 62 | 5 | 67 |
| 2014 October | 77 | 10 | 87 |
| 2014 September | 63 | 9 | 72 |
| 2014 August | 62 | 9 | 71 |
| 2014 July | 52 | 8 | 60 |
| 2014 June | 60 | 10 | 70 |
| 2014 May | 69 | 8 | 77 |
| 2014 April | 66 | 7 | 73 |
| 2014 March | 57 | 11 | 68 |
| 2014 February | 65 | 13 | 78 |
| 2014 January | 47 | 5 | 52 |
| 2013 December | 49 | 8 | 57 |
| 2013 November | 33 | 9 | 42 |
| 2013 October | 42 | 8 | 50 |
| 2013 September | 44 | 10 | 54 |
| 2013 August | 44 | 18 | 62 |
| 2013 July | 63 | 11 | 74 |
| 2013 June | 53 | 11 | 64 |
| 2013 May | 42 | 9 | 51 |
| 2013 April | 28 | 5 | 33 |
| 2013 March | 10 | 1 | 11 |
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