title: Transection of more than one sympathetic chain ganglion for hyperhidrosis increases the severity of compensatory hyperhidrosis and decreases patient satisfaction.
abstract: Sympathectomy (ETS) is an effective treatment for hyperhidrosis (HH), but compensatory hyperhidrosis (CH) is a common side effect. We reviewed our experience with 200 patients. Two hundred patients were retrospectively analyzed. Patients completed a questionnaire regarding their postoperative symptoms [% improvement score (IS), CH score], and their level of dissatisfaction, which was assessed as a function of regretting the choice to undergo ETS. Significance set at P< or =0.05. There were 123 (61.5%) females. Mean age was 28.2+/-7.4. Follow-up (mo) was 20.9+/-12.1. One ganglion was transected in 112 (56%) patients (G1), and more than one in 88 (G2). Overall, 157 (78.5%) patients had CH, 88 (74.1%) patients in G1 and 74 (84.1%) in G2, P=0.06. Patients in G2 had a higher CH score (4.1+/-2.7 versus 3.0+/-2.5, P<0.01), and a higher number of patients regretting surgery (11.4% versus 3.6%, P=0.05). Multivariate analysis showed age, high CH score, and surgery on T2 as independent predictors of patient's dissatisfaction (P<0.05). Patients with more than one ganglion transected demonstrate a trend toward a higher incidence of CH, a significantly higher CH score, and are more dissatisfied with ETS. Age, surgery on T2, and high CH score are independent predictors of patient's dissatisfaction.
authors.affiliation: Division of Cardiothoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. benny.weksler@jefferson.edu
authors.forename: Benny
authors.initials: B
authors.lastname: Weksler
authors.forename: Gayley
authors.initials: G
authors.lastname: Blaine
authors.forename: Zemilson B B
authors.initials: ZB
authors.lastname: Souza
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Gavina
mesh_terms: D000328:Adult; D005260:Female; D005728:Ganglia, Sympathetic / Q000601:surgery*; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013562:Sympathectomy / Q000009:adverse effects*; D055815:Young Adult