Hyperhidrosis of the Main Site of Complaint [5] Videothoracoscopic

Hyperhidrosis (HH) is a common
disorder characterized by excessive sweating beyond physiological need
for thermal regulation.1,2
It can significantly
impair an individual’s quality of life.3
Hyperhidrosis can be classified as being primary or secondary. Primary
hyperhidrosis (PH) occurs due to over-activity of the sympathetic
nervous system; however, the cause of this over-activity is unknown. Primary
hyperhidrosis usually presents symmetrically and often affects the armpits,
palms, and soles. Secondary hyperhidrosis (SH) can be attributed to known
factors including: infections, antidepressant use, neurologic abnormalities,
diabetes mellitus, excessive stress, and obesity. However, both primary and
secondary hyperhidrosis, can negatively affect daily social and physical
activities and lead to psychological distress. Several clinical treatments have
been used to treat hyperhidrosis, including antiperspirant use, iontophoresis,
anticholinergic drugs such as oxybutynin, and local botulinum toxin A
injections. However, these treatments often provide relief in only a small
fraction of patients, have numerous side effects, can prove to be costly, and
often lose their effectiveness over time. Sometimes, clinical treatments may depend on the location of
hyperhidrosis. In example, the topical anticholinergic agent glycopyrrolate,
oxybutynin, and intradermal botulinum toxin A injections have been described as
first-line therapies for facial hyperhidrosis (FH) due to their efficacy and
favorable safety profile.4

 

Video-assisted
thorascopic sympathectomy (VATS), also known as Endoscopic Thoracic Sympathectomy ETS, is a minimal-invasive
method for definitive primary hyperhidrosis treatment.5 VATS
utilizes video equipment to create small skin incisions to allow surgeons to
clip the nerve(s) responsible for hyperhidrosis on the thoracic sympathetic
chain.6 (VATS) is reserved for more
severe cases refractory to common first-line agents.7 VATS
has become widely accepted as a safe, highly successful treatment for
hyperhidrosis that provides immediate definitive hyperhidrosis relief;
additionally, VATS is associated with a rapid postoperative recovery, low
overall morbidity, and minimal external scars. Nevertheless, compensatory
hyperhidrosis (CH) is usually a troublesome consequence, particularly to facial
hyperhidrosis, where the thoracic sympathetic chain is interrupted at a higher
level, usually level T2.8

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Hence,
it is necessary to compare the quality of life experienced by patients when
suffering from compensatory hyperhidrosis versus primary hyperhidrosis. Our objective
is to conduct a small scale systematic literature review to evaluate the
quality of life related to hyperhidrosis before and after VATS, in relation to
satisfaction of patients with the surgery, the presence and effects compensatory
hyperhidrosis on patients post-operatively, and long-term patient quality of
life satisfaction post-VATS.9
Additionally, we aim to explore the prevalence and factors leading to patients pursing
repeat sympathectomy
for initial failed operations.

1 Single-port one-stage bilateral
thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of
a standardized approach

2 Evaluation of the quality of life of patients with primary
hyperhidrosis submitted to videothoracoscopic sympathectomy

3 Single-port one-stage bilateral thoracoscopic
sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized
approach

4 Video-Assisted Thoracoscopic Sympathectomy for Facial
Hyperhidrosis: The Influence of the Main Site of Complaint

5 Videothoracoscopic Sympathectomy Results
after Oxybutynin Chloride Treatment Failure

6 Evaluation of the quality of life of patients with primary
hyperhidrosis submitted to videothoracoscopic sympathectomy

7 Video-Assisted
Thoracoscopic Sympathectomy for Facial Hyperhidrosis: The Influence of the Main
Site of Complaint

8 Video-Assisted Thoracoscopic Sympathectomy
for Facial Hyperhidrosis: The Influence of the Main Site of Complaint

9 Evaluation of the quality of life of patients with primary
hyperhidrosis submitted to videothoracoscopic sympathectomy

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