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Endoscopic lumbar sympathectomy for women: effect on compensatory sweat.

Loureiro Mde P, de Campos JR, Kauffman P, Jatene FB, Weigmann S, Fontana A - Clinics (Sao Paulo) (2008)

Bottom Line: Group B, p<0.05).These patients also developed higher values of sweat measurements on specific points of their dorsal and abdominal regions after the procedure (p<0.05).However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body.

View Article: PubMed Central - PubMed

Affiliation: Programa de Pós-Graduação em Ciências - Cirurgia Torácica e Cardiovascular, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. mloureiro@unicenp.edu.br

ABSTRACT

Introduction: Plantar hyperhidrosis is present in 50% of patients with hyperhidrosis. Thoracic sympathectomy is an important tool for the treatment of this condition, which is successful in about 60% of patients. For the remaining patients, lumbar sympathectomy is the procedure of choice. As new minimally invasive techniques have been developed, a significant demand for this type of access has led to its adaptation to the lumbar sympathectomy. The objective of this study was to evaluate the effectiveness of endoscopic retroperitoneal lumbar sympathectomy in controlling plantar hyperhidrosis and its effects on compensatory sweat.

Materials and methods: Thirty female patients with persistent plantar hyperhidrosis after thoracic sympathectomy were enrolled. They were randomly assigned to laparoscopic retroperitoneal lumbar sympathectomy (Group A) or no surgical intervention (Group B - control) groups. Quality-of-life modifications were assessed by specific questionnaires before and after surgery. In the same manner, direct sweat measurements were also performed pre- and post-intervention by evaluating trans-epidermal water loss. Despite the lack of intervention, the control group was evaluated at similar timepoints.

Results: In Group A, no major complications occurred in the peri-operative period. During the immediate post-operative period, three patients (20%) experienced prolonged pain (more than ten days). Eight patients suffered from worsened compensatory sweating (53.3%). In Group A, after lumbar sympathectomy, the quality of life significantly improved (p<0.05, intra-group comparison) beyond that of the control group (p<0.05, inter-group comparison). Also, lumbar sympathectomy resulted in significantly lower values of foot sweat (pre- vs. post-operative periods, p<0.05; Group A vs. Group B, p<0.05). These patients also developed higher values of sweat measurements on specific points of their dorsal and abdominal regions after the procedure (p<0.05).

Conclusions: The endoscopic retroperitoneal lumbar sympathectomy diminishes plantar sweat and improves the quality of life of women with plantar hyperhidrosis. However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body.

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Related in: MedlinePlus

Comparison between the QOL scores of the control group in the interview of 6 months and the test group after the VRLS. Control group in blue and test group in red (p< 0.05)
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f7-cln63_2p0189: Comparison between the QOL scores of the control group in the interview of 6 months and the test group after the VRLS. Control group in blue and test group in red (p< 0.05)

Mentions: Six months after ERLS, the QOL scores in the test group were compared to control group results. A considerable difference between the groups (means of 26.33 and 47.6, respectively) was observed (Figure 7). After ERLS, patients in the test group presented with a greater improvement in QOL relative to the control group patients.


Endoscopic lumbar sympathectomy for women: effect on compensatory sweat.

Loureiro Mde P, de Campos JR, Kauffman P, Jatene FB, Weigmann S, Fontana A - Clinics (Sao Paulo) (2008)

Comparison between the QOL scores of the control group in the interview of 6 months and the test group after the VRLS. Control group in blue and test group in red (p< 0.05)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2664219&req=5

f7-cln63_2p0189: Comparison between the QOL scores of the control group in the interview of 6 months and the test group after the VRLS. Control group in blue and test group in red (p< 0.05)
Mentions: Six months after ERLS, the QOL scores in the test group were compared to control group results. A considerable difference between the groups (means of 26.33 and 47.6, respectively) was observed (Figure 7). After ERLS, patients in the test group presented with a greater improvement in QOL relative to the control group patients.

Bottom Line: Group B, p<0.05).These patients also developed higher values of sweat measurements on specific points of their dorsal and abdominal regions after the procedure (p<0.05).However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body.

View Article: PubMed Central - PubMed

Affiliation: Programa de Pós-Graduação em Ciências - Cirurgia Torácica e Cardiovascular, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. mloureiro@unicenp.edu.br

ABSTRACT

Introduction: Plantar hyperhidrosis is present in 50% of patients with hyperhidrosis. Thoracic sympathectomy is an important tool for the treatment of this condition, which is successful in about 60% of patients. For the remaining patients, lumbar sympathectomy is the procedure of choice. As new minimally invasive techniques have been developed, a significant demand for this type of access has led to its adaptation to the lumbar sympathectomy. The objective of this study was to evaluate the effectiveness of endoscopic retroperitoneal lumbar sympathectomy in controlling plantar hyperhidrosis and its effects on compensatory sweat.

Materials and methods: Thirty female patients with persistent plantar hyperhidrosis after thoracic sympathectomy were enrolled. They were randomly assigned to laparoscopic retroperitoneal lumbar sympathectomy (Group A) or no surgical intervention (Group B - control) groups. Quality-of-life modifications were assessed by specific questionnaires before and after surgery. In the same manner, direct sweat measurements were also performed pre- and post-intervention by evaluating trans-epidermal water loss. Despite the lack of intervention, the control group was evaluated at similar timepoints.

Results: In Group A, no major complications occurred in the peri-operative period. During the immediate post-operative period, three patients (20%) experienced prolonged pain (more than ten days). Eight patients suffered from worsened compensatory sweating (53.3%). In Group A, after lumbar sympathectomy, the quality of life significantly improved (p<0.05, intra-group comparison) beyond that of the control group (p<0.05, inter-group comparison). Also, lumbar sympathectomy resulted in significantly lower values of foot sweat (pre- vs. post-operative periods, p<0.05; Group A vs. Group B, p<0.05). These patients also developed higher values of sweat measurements on specific points of their dorsal and abdominal regions after the procedure (p<0.05).

Conclusions: The endoscopic retroperitoneal lumbar sympathectomy diminishes plantar sweat and improves the quality of life of women with plantar hyperhidrosis. However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body.

Show MeSH
Related in: MedlinePlus