title: Objective evaluation of plantar hyperhidrosis after sympathectomy.
abstract: OBJECTIVE
  The aim of the present study was to prospectively, randomly, blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter).
  
  
  METHODS
  From February 2007 to May 2009, 40 consecutive patients with combined palmar hyperhidrosis and plantar hyperhidrosis underwent video-assisted thoracic sympathectomy at the T3 or T4 ganglion level (15 women and 25 men, with a mean age of 25 years).
  
  
  RESULTS
  Immediately after the operation and during the one-year follow-up, all of the patients were free from palmar hyperhidrosis episodes. Compensatory hyperhidrosis of varying degrees was observed in 35 (87.5%) patients after one year. Only two (2.5%) patients suffered from severe compensatory hyperhidrosis. There was a large initial improvement in plantar hyperhidrosis in 46.25% of the cases, followed by a progressive regression of that improvement, such that only 30% continued to show this improvement after one year. The proportion of patients whose condition worsened increased progressively (from 21.25% to 47.50%), and the proportion of stable patients decreased (32.5% to 22.50%). This was not related to resection level; however, a lower intensity of plantar hyperhidrosis prior to sympathectomy correlated with worse evolution.
  
  
  CONCLUSIONS
  Patients with palmar hyperhidrosis and plantar hyperhidrosis who underwent video-assisted thoracic sympathectomy to treat their palmar hyperhidrosis exhibited good initial improvement in plantar hyperhidrosis, which then decreased to lesser degrees of improvement over a one-year period following the surgery. For this reason, video-assisted thoracic sympathectomy should not be performed when only plantar hyperhidrosis is present.
authors: Division of Vascular and Endovascular Surgery, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. wolosker@yahoo.com.br
authors: Nelson
authors: N
authors: Wolosker
authors: Augusto
authors: A
authors: Ishy
authors: Guilherme
authors: G
authors: Yazbek
authors: Jose Ribas Milanez de
authors: JR
authors: Campos
authors: Paulo
authors: P
authors: Kauffman
authors: Pedro
authors: P
authors: Puech-Leão
authors: Fabio Biscegli
authors: FB
authors: Jatene
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005534:Foot Diseases / Q000601:surgery*; D005725:Ganglia, Autonomic / Q000601:surgery; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D012008:Recurrence; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
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