Original Article
Compensatory Sweating After Upper Thoracic Sympathectomy. Prospective Study of 123 Cases
J. Moyaa,b,
, R. Ramosa,b, N. Vivesc, J. Péreza, R. Moreraa, V. Pernaa, R. Villalongad, G. Ferrera
Corresponding author
jmoya@ub.edu
Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. C/ Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. C/ Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
a Servicio de Cirugía Torácica, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
b Departament d'Anatomia Humana i Embriología, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
c Servicio de Medicina Preventiva, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
d Departament d'Anestesiologia i Reanimació, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
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Prospective Study of 123 Cases" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "360" "paginaFinal" => "363" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Moya, R. Ramos, N. Vives, J. Pérez, R. Morera, V. Perna, R. Villalonga, G. Ferrer" "autores" => array:8 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "J." "apellidos" => "Moya" "email" => array:1 [ 0 => "jmoya@ub.edu" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Ramos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "N." "apellidos" => "Vives" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "R." "apellidos" => "Morera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:3 [ "nombre" => "V." "apellidos" => "Perna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 6 => array:3 [ "nombre" => "R." "apellidos" => "Villalonga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 7 => array:3 [ "nombre" => "G." "apellidos" => "Ferrer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departament d'Anatomia Humana i Embriología, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Preventiva, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Departament d'Anestesiologia i Reanimació, Hospital Universitari de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. C/ Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-11-19" "fechaAceptado" => "2004-02-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153577" "palabras" => array:4 [ 0 => "Primary hyperhidrosis" 1 => "Compensatory sweating" 2 => "Social consequences" 3 => "Extension of sympathectomy." ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153578" "palabras" => array:4 [ 0 => "Hiperhidrosis primaria" 1 => "Sudación compensatoria" 2 => "Repercusión social" 3 => "Extensión de la simpaticólisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The most unpleasant consequence of upper thoracic sympathectomy is compensatory sweating (CS). Depending on the series, the incidence of CS ranges from 24% to 85%. The aim of this study was to determine the relation between CS and the following factors: distribution of hyperhidrosis, procedure performed (unilateral, synchronic bilateral, or sequential bilateral), and number of sympathetic ganglia eliminated. In addition, the degree of patient satisfaction was recorded as objectively as possible.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Prospective study of 123 patients who underwent upper thoracic sympathectomy for palmar and/or axillary hyperhidrosis between 1 January, 1996 and 1 June, 2002 at our unit. All patients completed a questionnaire on symptoms 8 weeks before and after surgery to determine postoperative changes in distribution of the hyperhidrosis and the overall degree of satisfaction on a scale of 0 to 4.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The sensation of CS was reported by 86.1% of the patients. When asked to relate this sensation to changes in sweating intensity in specific parts of the body, 46.54% reported CS and 48.37% no change. The trunk was the only region where statistically significant increases in CS occurred; in the feet, a decrease in sweating was noted. No differences in CS were observed with respect to the type of surgery or the number of sympathetic ganglia eliminated. The overall results were considered very satisfactory or quite satisfactory by 84.55% of the patients, while 4.88% were very dissatisfied.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Although CS is a side effect of upper thoracic sympathectomy, not all patients are affected by it. Significant CS occurs mainly in the back, chest, and abdomen. Neither the type of intervention nor the number of ganglia eliminated has an effect on CS. This side effect notwithstanding, overall satisfaction with the treatment is very satisfactory given that the palmar hyperhidrosis is eliminated.</p><p class="elsevierStyleSimplePara elsevierViewall">Sudación compensatoria secundaria a la simpaticólisis torácica superior. Estudio prospectivo de 123 casos</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La consecuencia más desagradable de la simpaticólisis torácica superior es la sudación compensatoria (SC), que oscila entre el 24 y el 85% según las series. El objetivo de este trabajo es determinar la relación de la SC en función de su distribución, del procedimiento realizado (unilateral, bilateral secuencial o sincrónica) y del número de ganglios simpáticos eliminados, así como registrar el grado de satisfacción obtenido, de la forma más objetiva.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de 123 pacientes intervenidos de simpaticólisis torácica superior por hiperhidrosis palmar y/o axilar, entre el 1 de enero de 1996 y el 1 de junio de 2002, en nuestro servicio. Todos ellos completaron, 8 semanas antes de la intervención y 8 semanas después, un cuestionario epidemiológico donde se registraban la distribución de la hiperhidrosis respecto a cómo era antes de la intervención y el grado de satisfacción global tras la intervención mediante una escala del 0 al 4.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La sensación de SC se presentó en el 86,1% de los pacientes. Al relacionar esta sensación con la variación de intensidad de la sudación en las diferentes partes del cuerpo, el 46,54% reconoció sufrir SC, mientras que el 48,37% no presentó cambios. Sólo las regiones del tronco habían experimentado cambios en cuanto a la SC de una forma estadísticamente significativa, y en los pies se apreció una disminución del sudor. No se observaron diferencias en cuanto al tipo de intervención realizada ni al número de ganglios eliminados. El grado de satisfacción global fue muy aceptable en el 84,55% de los pacientes, mientras que un 4,88% no aceptaron el resultado de la intervención.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La SC es un efecto secundario de la simpaticólisis torácica superior que no se presenta en la totalidad de los pacientes intervenidos. Predomina en la espalda, el tórax y el abdomen de manera significativa. No se ve modificada por el tipo de intervención ni por el número de ganglios eliminados. A pesar de este efecto secundario, la satisfacción global de la intervención es muy aceptable dada la eliminación de la hiperhidrosis palmar.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of palmar hyperhidrosis before thoracoscopy: experience with 475 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R Adar" 1 => "A Kurchin" 2 => "A Zweig" 3 => "M Mozes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Suppl" "fecha" => "1994" "volumen" => "572" "paginaInicial" => "9" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7524790" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hiperhidrosis primaria: estudio prospectivo de 338 pacientes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R Ramos" 1 => "J Moya" 2 => "J Pérez" 3 => "R Villalonga" 4 => "R Morera" 5 => "R Pujol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin(Barc)" "fecha" => "2003" "volumen" => "121" "paginaInicial" => "201" "paginaFinal" => "203" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The regional distribution of emotional sweating in man" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "JA Allen" 1 => "JE Armstrong" 2 => "IC Roddie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Physiol" "fecha" => "1973" "volumen" => "235" "paginaInicial" => "749" "paginaFinal" => "759" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4772406" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitation and regional distribution of sweat glands in man" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "WC Randal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1172/JCI101760" "Revista" => array:6 [ "tituloSerie" => "J Clin Invest" "fecha" => "1946" "volumen" => "25" "paginaInicial" => "761" "paginaFinal" => "767" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16695370" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M Kux" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Surg" "fecha" => "1978" "volumen" => "113" "paginaInicial" => "264" "paginaFinal" => "266" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/637691" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simpatectomía torácica endoscópica en el tratamiento de la hiperhidrosis palmar primaria. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 3 | 9 |
| 2024 October | 35 | 14 | 49 |
| 2024 September | 29 | 14 | 43 |
| 2024 August | 57 | 36 | 93 |
| 2024 July | 19 | 20 | 39 |
| 2024 June | 40 | 24 | 64 |
| 2024 May | 36 | 21 | 57 |
| 2024 April | 16 | 23 | 39 |
| 2024 March | 21 | 13 | 34 |
| 2024 February | 23 | 23 | 46 |
| 2023 March | 2 | 2 | 4 |
| 2023 February | 15 | 19 | 34 |
| 2023 January | 17 | 36 | 53 |
| 2022 December | 25 | 28 | 53 |
| 2022 November | 13 | 27 | 40 |
| 2022 October | 18 | 33 | 51 |
| 2022 September | 16 | 32 | 48 |
| 2022 August | 15 | 49 | 64 |
| 2022 July | 20 | 42 | 62 |
| 2022 June | 11 | 29 | 40 |
| 2022 May | 19 | 33 | 52 |
| 2022 April | 20 | 21 | 41 |
| 2022 March | 14 | 33 | 47 |
| 2022 February | 15 | 36 | 51 |
| 2022 January | 18 | 40 | 58 |
| 2021 December | 14 | 34 | 48 |
| 2021 November | 14 | 41 | 55 |
| 2021 October | 18 | 35 | 53 |
| 2021 September | 13 | 38 | 51 |
| 2021 August | 15 | 39 | 54 |
| 2021 July | 15 | 39 | 54 |
| 2021 June | 12 | 35 | 47 |
| 2021 May | 12 | 30 | 42 |
| 2021 April | 16 | 50 | 66 |
| 2021 March | 21 | 23 | 44 |
| 2021 February | 10 | 14 | 24 |
| 2021 January | 8 | 11 | 19 |
| 2020 December | 6 | 15 | 21 |
| 2020 November | 10 | 13 | 23 |
| 2020 October | 11 | 13 | 24 |
| 2020 September | 13 | 7 | 20 |
| 2020 August | 10 | 11 | 21 |
| 2020 July | 10 | 19 | 29 |
| 2020 June | 15 | 9 | 24 |
| 2020 May | 23 | 12 | 35 |
| 2020 April | 10 | 9 | 19 |
| 2020 March | 12 | 12 | 24 |
| 2020 February | 16 | 6 | 22 |
| 2020 January | 12 | 12 | 24 |
| 2019 December | 13 | 19 | 32 |
| 2019 November | 17 | 17 | 34 |
| 2019 October | 8 | 9 | 17 |
| 2019 September | 19 | 15 | 34 |
| 2019 August | 12 | 19 | 31 |
| 2019 July | 9 | 21 | 30 |
| 2019 June | 4 | 12 | 16 |
| 2019 May | 16 | 19 | 35 |
| 2019 April | 19 | 14 | 33 |
| 2019 March | 13 | 26 | 39 |
| 2019 February | 8 | 13 | 21 |
| 2019 January | 3 | 9 | 12 |
| 2018 December | 11 | 18 | 29 |
| 2018 November | 11 | 7 | 18 |
| 2018 October | 19 | 17 | 36 |
| 2018 September | 11 | 14 | 25 |
| 2018 May | 9 | 1 | 10 |
| 2018 April | 8 | 7 | 15 |
| 2018 March | 2 | 5 | 7 |
| 2018 February | 3 | 7 | 10 |
| 2018 January | 7 | 15 | 22 |
| 2017 December | 5 | 11 | 16 |
| 2017 November | 4 | 12 | 16 |
| 2017 October | 3 | 9 | 12 |
| 2017 September | 2 | 5 | 7 |
| 2017 August | 6 | 15 | 21 |
| 2017 July | 3 | 10 | 13 |
| 2017 June | 7 | 27 | 34 |
| 2017 May | 7 | 12 | 19 |
| 2017 April | 5 | 7 | 12 |
| 2017 March | 3 | 5 | 8 |
| 2017 February | 7 | 3 | 10 |
| 2017 January | 5 | 2 | 7 |
| 2016 December | 21 | 10 | 31 |
| 2016 November | 23 | 10 | 33 |
| 2016 October | 23 | 12 | 35 |
| 2016 September | 12 | 5 | 17 |
| 2016 August | 5 | 3 | 8 |
| 2016 July | 9 | 3 | 12 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 45 | 1 | 46 |
| 2015 September | 68 | 10 | 78 |
| 2015 August | 43 | 5 | 48 |
| 2015 July | 36 | 8 | 44 |
| 2015 June | 32 | 9 | 41 |
| 2015 May | 42 | 11 | 53 |
| 2015 April | 30 | 11 | 41 |
| 2015 March | 45 | 8 | 53 |
| 2015 February | 18 | 5 | 23 |
| 2015 January | 27 | 6 | 33 |
| 2014 December | 40 | 4 | 44 |
| 2014 November | 41 | 16 | 57 |
| 2014 October | 49 | 11 | 60 |
| 2014 September | 29 | 13 | 42 |
| 2014 August | 27 | 12 | 39 |
| 2014 July | 28 | 14 | 42 |
| 2014 June | 30 | 9 | 39 |
| 2014 May | 46 | 8 | 54 |
| 2014 April | 41 | 7 | 48 |
| 2014 March | 42 | 9 | 51 |
| 2014 February | 46 | 9 | 55 |
| 2014 January | 53 | 10 | 63 |
| 2013 December | 41 | 10 | 51 |
| 2013 November | 27 | 8 | 35 |
| 2013 October | 34 | 9 | 43 |
| 2013 September | 42 | 9 | 51 |
| 2013 August | 42 | 16 | 58 |
| 2013 July | 50 | 18 | 68 |
| 2013 June | 37 | 13 | 50 |
| 2013 May | 37 | 10 | 47 |
| 2013 April | 15 | 5 | 20 |
| 2013 March | 4 | 1 | 5 |
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