Management of Compensatory Sweating After Sympathetic Surgery.
Compensatory hyperhidrosis (HH) is the most common and feared side effect of thoracic sympathectomy, because patients with severe forms have their quality of life greatly impaired. The most well-known factors associated with compensatory HH are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Technical developments as well as the proper selection of patients for surgery have been crucial in reducing the occurrence of severe forms of compensatory HH. Therapeutic options include topical agents, botulinum toxin, systemic anticholinergics, clip removal, and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods.
Division of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco A1, 4° Andar, Sala 423 - Morumbi, São Paulo CEP 05652-000, Brazil; Division of Vascular and Endovascular Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, R. Dr. Enéas de Carvalho Aguiar, 255 - Instituto Central, 9° Andar, Sala 9117 - Cerqueira César, São Paulo CEP 05403-000, Brazil.
Nelson
N
Wolosker
Division of Thoracic Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco A1, 4° Andar, Sala 423 - Morumbi, São Paulo CEP 05652-000, Brazil; Division of Thoracic Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, R. Dr. Enéas de Carvalho Aguiar, 255 - Instituto Central, 9° Andar, Sala 9117 - Cerqueira César, São Paulo CEP 05403-000, Brazil.
José Ribas
JR
Milanez de Campos
Division of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627 - Bloco A1, 4° Andar, Sala 423 - Morumbi, São Paulo CEP 05652-000, Brazil. Electronic address: ju_mfukuda@yahoo.com.
Juliana Maria
JM
Fukuda
D003131:Combined Modality Therapy; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D013546:Sweating / Q000502:physiology*; D013562:Sympathectomy / Q000379:methods; D013906:Thoracoscopy
Cholinergic antagonists; Hyperhidrosis; Sweating; Sympathectomy; Sympathetic nervous system