Abstract
Compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy. The study aimed to reduce compensatory hyperhidrosis to increase patients’ satisfaction. A prospective randomized study on palmar hyperhidrosis, May 2016–September 2019. Twenty-one patients T3–T4 sympathicotomy and 21 T3–T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and recommend it. No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50–63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75–27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was. T3–T4 gray ramicotomy had better results than T3–T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.
Highlights
Compensatory hyperhidrosis is the leading cause of patients’ dissatisfaction after thoracic sympathicotomy
This chain’s surgical section, known as sympathicotomy (SY), is commonplace at different levels[19,20,21]. This leaves the axillae, hands, face, and head with no possibility of sweating and temperature r egulation[22,23]. It has to be kept in mind that this area, the upper part of the body, represents 40% of the area through which we control our temperature by heat dissipation through sweating[24]
We evaluated the incidence of pleural adhesions found in the surgical procedure, the time to undertake the operation on each side, the postoperative complications, the hospital stay, and the recurrence rate
Summary
Compensatory hyperhidrosis is the leading cause of patients’ dissatisfaction after thoracic sympathicotomy. Just after the TS patients are pleased as they do not longer sweat in the areas where it was incredibly cumbersome (hands and axillae)[9], but as time goes by, especially during the summer, they notice sweating in areas that did not sweat before or not to such an extent, such as the abdomen, torso, buttocks, and thighs[10] This new sweating is known as compensatory hyperhidrosis (CH) and is the fundamental cause of long-term patients’. This chain’s surgical section, known as sympathicotomy (SY), is commonplace at different levels[19,20,21] This leaves the axillae, hands, face, and head with no possibility of sweating and temperature r egulation[22,23]. Many agree that the number of sympathetic ganglia injured should include only T3 and T418,27–29
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