Predictive procedure for compensatory hyperhidrosis before sympathectomy: preliminary findings.
OBJECTIVE
Compensatory hyperhidrosis is one of the most common and serious adverse effects following sympathectomy. We performed a local anesthetic procedure that predicts the occurrence and severity of compensatory hyperhidrosis, and evaluated the feasibility, safety, and efficacy of the procedure.


METHODS
From July 2009 to July 2010, 20 patients with severe primary palmar hyperhidrosis underwent predictive procedures. A sympathetic nerve block was obtained via thoracoscopic approach under local anesthesia. The patients were evaluated for compensatory hyperhidrosis 1 week after the procedure before deciding whether to proceed with sympathectomy.


RESULTS
Of the 20 patients, 17 patients proceeded with sympathectomy and 3 refused the final procedure. Following sympathectomy, the occurrence and severity of compensatory hyperhidrosis in the remaining 17 patients were statistically analyzed with two tailed paired t test, and there is no significant difference between the predictive and final procedures (t = 1.69, df = 16, p > 0.1).


CONCLUSIONS
Predictive procedure using local anesthesia to detect compensatory hyperhidrosis before sympathectomy may be useful for helping patients to decide whether to undergo the operation.
Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Jin Yong
JY
Jeong
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Hyung Joo
HJ
Park
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Jae Kil
JK
Park
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Keon Hyeon
KH
Jo
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Young Pil
YP
Wang
Department of Thoracic and Cardiovascular Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea.
Jongho
J
Lee
Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University Medical Center, Ansan, Republic of Korea.
Jae Seong
JS
Shin
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000494:pharmacology*; D001340:Autonomic Nerve Block; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D008297:Male; D011300:Preoperative Care; D013562:Sympathectomy / Q000009:adverse effects*; D013564:Sympathetic Nervous System / Q000187:drug effects; D016896:Treatment Outcome; D055815:Young Adult
D000779:Anesthetics, Local