The influence of compensatory sweating on the satisfaction of patients subjected to thoracoscopic sympathectomy/ Influencia da hiper-hidrose reflexa na satisfacao do paciente operado

Hyperhidrosis is the excessive increase in sweating, for which thoracoscopic sympathectomy is the first method of treatment. Compensatory hyperhidrosis is the main cause of dissatisfaction for patients. The present work aims to study retrospectively the incidence of compensatory sweating and its influence on patient satisfaction. From February 1997 to February 2003, 216 patients with primary hyperhidrosis were operated. The data were obtained on the first postoperative month, using a questionnaire. The compensatory sweating was subjectively classified as mild, moderate or severe. In the operated patients, thoracic pain lasting more than one week was the most common postoperative complication (0.4%). The success rate was 100% for palmar, 90% for axillary and 40% for plantar hyperhidrosis. Compensatory Hyperhidrosis was found in 85.64%. Despite this, the majority of the patients (87.03%) were satisfied with the surgery. Thus, thoracoscopic sympathectomy is an efficient method to treat primary hyperhidrosis, which has compensatory hyperidrosis as its main side effect. The reason why the patients who presented severe compensatory sweating would submit to surgery again still needs more prospective multicentric studies involving suitable psychiatric studies. Key words: hyperhidrosis, sympathectomy thoracoscopic, compensatory hyperhidrosis, compensatory sweating. Hiper-hidrose e o aumento excessivo do suor, cujo tratamento de escolha e a simpatectomia videotoracoscopica, e a hiper-reflexia e o principal motivo de insatisfacao relatada pelos pacientes operados. O estudo teve por objetivo estudar, retrospectivamente, a incidencia de hiper-hidrose reflexa e sua influencia na satisfacao do paciente. Entre fevereiro de 1997 e fevereiro de 2003, foram operados 216 pacientes com hiper-hidrose primaria. As informacoes foram obtidas no primeiro mes de pos-operatorio, por meio de um questionario. A hiper-reflexia foi classificada subjetivamente em intensa, moderada e leve. Nos 216 pacientes operados, a dor toracica com duracao maior que uma semana foi a complicacao pos-operatoria mais encontrada (0,4%). O indice terapeutico para a hiperhidrose palmar foi de 100%, axilar 90 e 40% para plantar. A hiper-hidrose reflexa foi encontrada em 85,64%. Apesar disso, a maioria dos pacientes (87,03%) estava satisfeita com a cirurgia. Em suma, simpatectomia videotoracoscopica e metodo eficiente e seguro para o tratamento da hiper-hidrose primaria, cujo principal efeito colateral (hiper-