Outcome of Limited Video-Assisted Lumbar Sympathetic Block for Plantar Hyperhidrosis Using Clipping Method.
BACKGROUND
There are many ways to treat focal hyperhidrosis, including surgeries for palmar and axillary hyperhidrosis. However, doctors and patients tend to be reluctant to perform surgery for plantar hyperhidrosis due to misconceptions and prejudices about surgical treatment. In addition, few studies have reported the outcome of surgeries for plantar hyperhidrosis. Therefore, the objective of this study was to determine the outcome (early and late postoperative satisfaction, complication, compensatory hyperhidrosis, recurrence rate, and efficiency) of surgical treatment for plantar hyperhidrosis.


METHODS
From August 2014 to October 2015, lumbar sympathetic block (LSB) was performed in 82 patients with plantar hyperhidrosis using clipping method. Limited video-assisted LSB was performed using 5 mm ligamax-clip or 3 mm horizontal-clip after identifying L3-4 sympathetic ganglion through finger-touch and endoscopic vision.


RESULTS
Of the 82 patients, 45 were male and 37 were female. Their mean age was 26.38 years (range, 14-51 years). Mean follow-up time was 6.60 ± 3.56 months. Mean early postoperative satisfaction score was 9.6 on the 10th day postoperative evaluation. At more than 1 month later, the mean late postoperative satisfaction score was 9.2. There was no significant difference in early postoperative satisfaction score between clipping level L3 and L4/5. However, late postoperative satisfaction score was significantly better in the L3 group than that in the L4/5 group. Patient's age and body mass index did not affect the satisfaction score. However, male patients and patients who had history of hyperhidrosis operation showed higher satisfaction score than others.


CONCLUSIONS
Limited video-assisted LSB using clip provided good results with minimal complications and low compensatory hidrosis, contrary to the prejudice toward it. Therefore, surgical treatment is recommended for plantar hyperhidrosis.
1 Dajung Chest Surgery , Suwon, Republic of Korea.
Seok Won
SW
Yun
2 Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan , College of Medicine, Ulsan, Republic of Korea.
Yun Seok
YS
Kim
2 Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan , College of Medicine, Ulsan, Republic of Korea.
Yongjik
Y
Lee
1 Dajung Chest Surgery , Suwon, Republic of Korea.
Han Jung
HJ
Lim
3 Da-jeong Clinic of Surgery , Ulsan, Republic of Korea.
Soon Ik
SI
Park
2 Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan , College of Medicine, Ulsan, Republic of Korea.
Jong Pil
JP
Jung
2 Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan , College of Medicine, Ulsan, Republic of Korea.
Chang Ryul
CR
Park
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D012008:Recurrence; D012737:Sex Factors; D013525:Surgical Instruments; D013562:Sympathectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
hyperhidrosis; lumbar sympathetic block; plantar hyperhidrosis