Effects of endoscopic thoracic sympathectomy for primary hyperhidrosis on cardiac autonomic nervous activity (original) (raw)
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Cardiopulmonary effects following endoscopic thoracic sympathectomy for primary hyperhidrosis☆
European Journal of Cardio-Thoracic Surgery, 2009
Introduction: Endoscopic thoracic sympathectomy (ETS) is performed for the treatment of primary hyperhidrosis (PH). The second and third sympathetic thoracic ganglions excised in ETS also innervate the heart and lung. Objective: In the present work we studied the cardiopulmonary effects of ETS in a group of patients with PH. Methods: We performed a prospective study in 38 patients with severe PH. Pulmonary function, echocardiographic assessment of left ventricular function and myocardial contractility and maximal, symptom-limited, incremental exercise tests were evaluated 2 weeks before, and 6 months after ETS. Data were analysed with the paired t-test. Differences were considered significant when p < 0.05. Results: In pulmonary function tests, we found a statistically significant decrease forced expiratory flow in small airways and an increase of residual volume, a significant decrease in heart rate and ejection fraction, a significant decrease of 'rest' and 'peak' heart rate, and a significant increase of oxygen pulse (O 2 pulse) and oxygen peak uptake (V O 2 peak) after ETS (p < 0.05). Conclusions: These cardiopulmonary effects observed 6 months after ETS in the treatment of patients with PH are all in normal ranges and are not relevant in cardiopulmonary function. We concluded that ETS in patients with PH is a safe procedure. Patients must be informed about these cardiopulmonary effects before the operation.
F1000Research
Background: Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition. This study will describe our experience in managing hyperhidrosis via endoscopic thoracic sympathectomy (ETS). Methods: The information was obtained from the patient records from 1st January 2011 until 31st December 2016. Pertinent information was extracted and keyed into a study proforma. Results: 150 patients were operated on but only 118 patients were included in this study. The mean age was 22.9±7.3 years. The majority (54.2%) had palmar-plantar hyperhidrosis and 39.8% had associated axillary hyperhidrosis. Excision of the sympathetic nerve chain and ganglia were the main surgical technique with the majority (55.9%) at T2-T3 level. Mean ETS procedure time was 46.6±14.29 minutes with no conversion. Surgical complications were minimal and no Horner’s Syndrome reported. Mean hospital stay was...
Compensatory hyperhidrosis following thoracic sympathectomy: a biophysical rationale
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2011
A side-effect of endoscopic thoracic sympathectomy (ETS) is compensatory hyperhidrosis (CH), characterized by excessive sweating from skin areas with intact sudomotor function. The physiological mechanism of CH is unknown, but may represent an augmented local sweat rate from skin areas with uninterrupted sympathetic innervation based on evaporative heat balance requirements. For a given combination of activity and climate, the same absolute amount of evaporation (if any) is needed to balance the rate of metabolic heat production both pre- and post-ETS. However, the rate of local sweating per unit of skin surface area with intact sudomotor activity must be greater post-ETS as evaporation must be derived from a smaller skin surface area. Under conditions with high evaporative requirements, greater degradations in sweating efficiency associated with an increased dripping of sweat should also occur post-ETS, further pronouncing the sweat rate required for heat balance. In conclusion, in...
F1000Research
Background: Endoscopic thoracic sympathectomy (ETS) is renowned as an effective surgical treatment for primary hyperhidrosis (PHH) and believed to improve patients’ quality of life (QOL). This study aimed to evaluate the quality of life (QOL) of patients with PHH after ETS compared to before ETS, and to determine whether compensatory sweating (CS) affects QOL of patients. Methods: This is a single-centre retrospective review of patients who had undergone ETS at the National Heart Center [Institut Jantung Negara (IJN)], Malaysia. In total, 62 patients from January 2014 to December 2018 were recruited. Medical records were first reviewed for all relevant data, prior to making telephone interview to administer the questionnaire. A modified questionnaire with validated components was used to assess the patients’ QOL. Patient satisfaction, symptom resolution, recurrence and occurrence of CS were also asked during the interview. Data were analysed using IBM SPSS Statistics 25.0. Results:...