Quality of life, before and after thoracic sympathectomy: report on 378 operated patients

JRM de Campos, P Kauffman… - The Annals of thoracic …, 2003 - Elsevier
JRM de Campos, P Kauffman, E de Campos Werebe, LO Andrade Filho, S Kusniek…
The Annals of thoracic surgery, 2003Elsevier
BACKGROUND: Thoracic sympathectomy is indicated to treat primary hyperhidrosis. The
objective is to analyze the results and complications of thoracic sympathectomy and propose
a questionnaire to assess the quality of life of patients. METHODS: Between October 1995
and March 2002, 378 patients were evaluated. Sixty-two percent were female, with a mean
age of 26.8 years old (range 9 to 70 years old). There were 57.4% patients with palmar-
plantar hyperhidrosis; 25% with palmar, plantar, and axillary hyperhidrosis; 15.7% with pure …
BACKGROUND
Thoracic sympathectomy is indicated to treat primary hyperhidrosis. The objective is to analyze the results and complications of thoracic sympathectomy and propose a questionnaire to assess the quality of life of patients.
METHODS
Between October 1995 and March 2002, 378 patients were evaluated. Sixty-two percent were female, with a mean age of 26.8 years old (range 9 to 70 years old). There were 57.4% patients with palmar-plantar hyperhidrosis; 25% with palmar, plantar, and axillary hyperhidrosis; 15.7% with pure axillary hyperhidrosis; and 6.5% with craniofacial hyperhidrosis. General anesthesia was used in 97.3%, epidural with sedation in 2.7%. The sympathetic chain was resected in 12.5%, thermal ablation with the electrical scalpel was performed in 66.3%, and with the harmonic scalpel in 21.2% of the patients.
RESULTS
Successful sympathectomies were performed in 90.3% of the patients; the follow-up was from 1 to 60 months (mean 12.4 ± 8.3 months). The recurrence rates were 8.2% for palmar hyperhidrosis, 13.7% for pure axillary hyperhidrosis, 27.5% of which were reoperated successfully. Improvement of the plantar hyperhidrosis was also registered in 58%. Horner's syndrome was reported in 1% with regression in half of them after 30 days. No mortality or serious complications were observed, nor the need to convert to thoracotomy. Of the total number of patients, 93.4% answered the quality of life questionnaire, 86.4% of whom noted improvement after the procedure.
CONCLUSIONS
Thoracic sympathectomy is a simple, effective, safe method for the treatment of hyperhidrosis, resulting in an improved quality of life for patients. The questionnaire documents this change.
Elsevier
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