[Bilateral dorsal sympathectomy for the treatment of primary hyperhidrosis: effects on lung function at 3 years].
BACKGROUND
Primary hyperhidrosis is characterized by excessive sweating of the palms, soles, and axillae due to overactivity of the sympathetic nervous system at the level of the second and third sympathetic thoracic ganglia. The treatment of choice is bilateral dorsal sympathectomy performed using video-assisted thoracic surgery (VATS). The objective of our study was to determine whether lung function changes observed in a group of patients prior to bilateral dorsal sympathectomy performed using VATS were still evident 3 years after surgery.


METHODS
Of the 20 patients studied at baseline, we were able to obtain data for 18 (3 men and 15 women; mean age, 35 y). They underwent spirometry and a bronchial challenge test with methacholine, and the fraction of exhaled nitric oxide (FE(NO)) was measured. The results were compared with those of the tests performed before surgery.


RESULTS
At 3 years from baseline, we detected a statistically significant increase in forced vital capacity from a mean (SD) of 96% (10%) to 101% (11%) (P=.008), and a statistically significant decrease in midexpiratory flow rate from 3.8 (0.9)L/s to 3.5 (0.9)L/s (P=.01). The results of the bronchial challenge test with methacholine and the FE(NO) remained unchanged.


CONCLUSIONS
The lung function changes detected point toward minimal, clinically insignificant small airway alterations due to sympathetic denervation following bilateral dorsal sympathectomy performed 3 years earlier.
Vigil
Laura
L
Unitat de Funció Pulmonar, Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Calaf
Núria
N
Feixas
Teresa
T
Casan
Pere
P
D000328:Adult; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology* / Q000601:surgery*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013147:Spirometry; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors