TITLE

Video assisted thoracoscopic re-sympathetic surgery in the treatment of re-sweating hyperhidrosis

AUTHOR(S)
Kim, Do Hyung; Paik, Hyo Chae; Lee, Doo Yun
PUB. DATE
May 2005
SOURCE
European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p741
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: The characteristics and causes of re-sweating after sympathetic surgery in hyperhidrosis patients have yet to be clearly documented due primarily to low incidence of re-sympathetic surgery. The purpose of this study is to identify the causes of re-sweating following sympathetic surgery, and to assess the outcomes of re-sympathetic surgery. Methods: From February 1997 to July 2003, 36 patients underwent re-sympathetic surgery in order to treat re-sweating. Patients originally underwent sympathetic surgery due to facial (14 cases), palmar (21 cases), and axillary (1 case) hyperhidrosis. Results: Sympathectomy was performed as a primary surgical intervention in 7 cases (19.4%), sympathicotomy in 12 cases (33.3%), and sympathetic clipping in 17 cases (47.3%). Thirteen patients complained of re-sweating on both sides, and 23 patients exhibited unilateral re-sweating. The onset of re-sweating occurred after an average of 3.1±3.4 months (range, 1–12 months) after the operation. The causes of re-sweating after sympathetic surgery included an intact sympathetic chain in 4 cases (11.1%), incomplete resection in 6 cases (16.7%), partial reattachment in 6 cases (16.7%), improper ganglion location in 4 cases (11.1%), clip slipping out in 11 cases (30.5%), and unknown in 5 cases (13.9%). Twenty-seven patients (75.0%) exhibited re-sweating within 3 months, and 9 patients (25.0%) experienced re-sweating after 6 months. During the second operation, sympathicotomy was performed in 20 cases (55.6%) and sympathetic clipping in 16 cases (44.4%) in which 32 patients (88.9%) reported decreased sweating. Conclusions: Surgical errors during the initial operation constituted the main cause of re-sweating following sympathetic surgery. Re-sympathetic surgery was necessary in order to treat re-sweating, and was associated with favorable outcomes.
ACCESSION #
17674385

 

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