Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis
Background The primary goal of this study is to identify clinical variables associated with successful surgical treatment for hyperhidrosis and facial blushing. Methods Six hundred eight thoracoscopic sympathicotomies were performed in 304 patients. Retrospective stratified analysis of patients afte...
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| Veröffentlicht in: | The Annals of thoracic surgery 2008-02, Vol.85 (2), p.390-394 |
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| creator | Kwong, King F., MD Hobbs, Jessica L., BS Cooper, Lindsay B., BS Burrows, Whitney, MD Gamliel, Ziv, MD Krasna, Mark J., MD |
| description | Background The primary goal of this study is to identify clinical variables associated with successful surgical treatment for hyperhidrosis and facial blushing. Methods Six hundred eight thoracoscopic sympathicotomies were performed in 304 patients. Retrospective stratified analysis of patients after thoracoscopic sympathicotomy for hyperhidrosis or facial blushing and having completed follow-up of at least 6 months (n = 232) was performed. Preoperative and postoperative quality-of-life indices (range, 0 to 3) were used to measure impact of surgery, and comparisons were indexed to preoperative symptoms. Postoperative compensatory sweating was analyzed with respect to the level(s) of sympathetic chain division. Results Thoracoscopic sympathicotomy was performed at level T2 alone in 5% of patients; levels T2 to T3 in 63% of patients; levels T3 to T4 in 3% of patients; levels T2 to T4 in 14% of patients; and more than three levels in 14% of patients. In hyperhidrosis patients, mean preoperative quality-of-life index was 2.0 and postoperative quality-of-life index was 0.4 ( p < 0.001). Facial blushers had preoperative and postoperative quality-of-life index of 2.6 and 1.0, respectively. Significant compensatory sweating was seen in 33% patients overall and occurred in 29% of patients with palmar symptoms, 26% of axillary patients, and 42% of facial blushers. Significant compensatory sweating in relation to the level(s) of sympathetic chain division occurred in T2 alone, 45%; T2 to T3, 30%; T3 to T4, 14%; T2 to T4, 38%; and more than three levels, 49%. Conclusions Significant improvement in quality of life can result from surgery for hyperhidrosis. However, the incidence of postoperative compensatory sweating may be dependent on the level of sympathicotomy performed. The choice of sympathicotomy level(s) should be directed toward reducing the incidence of significant compensatory sweating while simultaneously ensuring relief of primary preoperative symptoms. |
| doi_str_mv | 10.1016/j.athoracsur.2007.08.001 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70241440</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0003497507016244</els_id><sourcerecordid>70241440</sourcerecordid><originalsourceid>FETCH-LOGICAL-c512t-5c943bc6e955fbc17c25954c1eb1e9da0dfafae35c15ddb9fc2e2ab3c7a46a293</originalsourceid><addsrcrecordid>eNqNUU1r3DAUFKWh2ab9C0Wn3OxKsrReXwrpko9CIIdNL70I-emJaGtbjmQH_O-j7S4EeoouQrx5M6MZQihnJWd8_X1fmukpRANpjqVgrC7ZpmSMfyArrpQo1kI1H8mKMVYVsqnVOfmc0j4_RR5_Iud8I_Kp-Ir82U3RTN55tPRqMN2SfKLB0W3nBw-mow_zBKHHRP1AH_9phgRh9EB3Sz9mGx7CFPqFuhDp3TJifPI2hkzzhZw50yX8erovyO-b68ftXXH_cPtre3VfgOJiKhQ0smphjY1SrgVeQzavJHBsOTbWMOuMM1gp4MratnEgUJi2gtrItRFNdUEuj7xjDM8zpkn3PgF2nRkwzEnXTEguJcvAzREI2V-K6PQYfW_iojnTh1z1Xr_lqg-5arbROde8-u2kMbc92rfFU5AZ8PMIwPzTF49RJ_A4AFofESZtg3-Pyo__SOBUw19cMO3DHHNFSXOdhGZ6d-j3UC-rM62QsnoFcHWmgw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70241440</pqid></control><display><type>article</type><title>Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Kwong, King F., MD ; Hobbs, Jessica L., BS ; Cooper, Lindsay B., BS ; Burrows, Whitney, MD ; Gamliel, Ziv, MD ; Krasna, Mark J., MD</creator><creatorcontrib>Kwong, King F., MD ; Hobbs, Jessica L., BS ; Cooper, Lindsay B., BS ; Burrows, Whitney, MD ; Gamliel, Ziv, MD ; Krasna, Mark J., MD</creatorcontrib><description>Background The primary goal of this study is to identify clinical variables associated with successful surgical treatment for hyperhidrosis and facial blushing. Methods Six hundred eight thoracoscopic sympathicotomies were performed in 304 patients. Retrospective stratified analysis of patients after thoracoscopic sympathicotomy for hyperhidrosis or facial blushing and having completed follow-up of at least 6 months (n = 232) was performed. Preoperative and postoperative quality-of-life indices (range, 0 to 3) were used to measure impact of surgery, and comparisons were indexed to preoperative symptoms. Postoperative compensatory sweating was analyzed with respect to the level(s) of sympathetic chain division. Results Thoracoscopic sympathicotomy was performed at level T2 alone in 5% of patients; levels T2 to T3 in 63% of patients; levels T3 to T4 in 3% of patients; levels T2 to T4 in 14% of patients; and more than three levels in 14% of patients. In hyperhidrosis patients, mean preoperative quality-of-life index was 2.0 and postoperative quality-of-life index was 0.4 ( p < 0.001). Facial blushers had preoperative and postoperative quality-of-life index of 2.6 and 1.0, respectively. Significant compensatory sweating was seen in 33% patients overall and occurred in 29% of patients with palmar symptoms, 26% of axillary patients, and 42% of facial blushers. Significant compensatory sweating in relation to the level(s) of sympathetic chain division occurred in T2 alone, 45%; T2 to T3, 30%; T3 to T4, 14%; T2 to T4, 38%; and more than three levels, 49%. Conclusions Significant improvement in quality of life can result from surgery for hyperhidrosis. However, the incidence of postoperative compensatory sweating may be dependent on the level of sympathicotomy performed. The choice of sympathicotomy level(s) should be directed toward reducing the incidence of significant compensatory sweating while simultaneously ensuring relief of primary preoperative symptoms.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/j.athoracsur.2007.08.001</identifier><identifier>PMID: 18222231</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Cardiothoracic Surgery ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Hyperhidrosis - diagnosis ; Hyperhidrosis - surgery ; Male ; Middle Aged ; Patient Satisfaction ; Probability ; Quality of Life ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Surgery ; Thoracic Nerves - surgery ; Thoracic Surgery, Video-Assisted - methods ; Thoracoscopy - methods ; Treatment Outcome</subject><ispartof>The Annals of thoracic surgery, 2008-02, Vol.85 (2), p.390-394</ispartof><rights>The Society of Thoracic Surgeons</rights><rights>2008 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c512t-5c943bc6e955fbc17c25954c1eb1e9da0dfafae35c15ddb9fc2e2ab3c7a46a293</citedby><cites>FETCH-LOGICAL-c512t-5c943bc6e955fbc17c25954c1eb1e9da0dfafae35c15ddb9fc2e2ab3c7a46a293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18222231$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kwong, King F., MD</creatorcontrib><creatorcontrib>Hobbs, Jessica L., BS</creatorcontrib><creatorcontrib>Cooper, Lindsay B., BS</creatorcontrib><creatorcontrib>Burrows, Whitney, MD</creatorcontrib><creatorcontrib>Gamliel, Ziv, MD</creatorcontrib><creatorcontrib>Krasna, Mark J., MD</creatorcontrib><title>Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background The primary goal of this study is to identify clinical variables associated with successful surgical treatment for hyperhidrosis and facial blushing. Methods Six hundred eight thoracoscopic sympathicotomies were performed in 304 patients. Retrospective stratified analysis of patients after thoracoscopic sympathicotomy for hyperhidrosis or facial blushing and having completed follow-up of at least 6 months (n = 232) was performed. Preoperative and postoperative quality-of-life indices (range, 0 to 3) were used to measure impact of surgery, and comparisons were indexed to preoperative symptoms. Postoperative compensatory sweating was analyzed with respect to the level(s) of sympathetic chain division. Results Thoracoscopic sympathicotomy was performed at level T2 alone in 5% of patients; levels T2 to T3 in 63% of patients; levels T3 to T4 in 3% of patients; levels T2 to T4 in 14% of patients; and more than three levels in 14% of patients. In hyperhidrosis patients, mean preoperative quality-of-life index was 2.0 and postoperative quality-of-life index was 0.4 ( p < 0.001). Facial blushers had preoperative and postoperative quality-of-life index of 2.6 and 1.0, respectively. Significant compensatory sweating was seen in 33% patients overall and occurred in 29% of patients with palmar symptoms, 26% of axillary patients, and 42% of facial blushers. Significant compensatory sweating in relation to the level(s) of sympathetic chain division occurred in T2 alone, 45%; T2 to T3, 30%; T3 to T4, 14%; T2 to T4, 38%; and more than three levels, 49%. Conclusions Significant improvement in quality of life can result from surgery for hyperhidrosis. However, the incidence of postoperative compensatory sweating may be dependent on the level of sympathicotomy performed. The choice of sympathicotomy level(s) should be directed toward reducing the incidence of significant compensatory sweating while simultaneously ensuring relief of primary preoperative symptoms.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiothoracic Surgery</subject><subject>Child</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hyperhidrosis - diagnosis</subject><subject>Hyperhidrosis - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Satisfaction</subject><subject>Probability</subject><subject>Quality of Life</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Thoracic Nerves - surgery</subject><subject>Thoracic Surgery, Video-Assisted - methods</subject><subject>Thoracoscopy - methods</subject><subject>Treatment Outcome</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUU1r3DAUFKWh2ab9C0Wn3OxKsrReXwrpko9CIIdNL70I-emJaGtbjmQH_O-j7S4EeoouQrx5M6MZQihnJWd8_X1fmukpRANpjqVgrC7ZpmSMfyArrpQo1kI1H8mKMVYVsqnVOfmc0j4_RR5_Iud8I_Kp-Ir82U3RTN55tPRqMN2SfKLB0W3nBw-mow_zBKHHRP1AH_9phgRh9EB3Sz9mGx7CFPqFuhDp3TJifPI2hkzzhZw50yX8erovyO-b68ftXXH_cPtre3VfgOJiKhQ0smphjY1SrgVeQzavJHBsOTbWMOuMM1gp4MratnEgUJi2gtrItRFNdUEuj7xjDM8zpkn3PgF2nRkwzEnXTEguJcvAzREI2V-K6PQYfW_iojnTh1z1Xr_lqg-5arbROde8-u2kMbc92rfFU5AZ8PMIwPzTF49RJ_A4AFofESZtg3-Pyo__SOBUw19cMO3DHHNFSXOdhGZ6d-j3UC-rM62QsnoFcHWmgw</recordid><startdate>20080201</startdate><enddate>20080201</enddate><creator>Kwong, King F., MD</creator><creator>Hobbs, Jessica L., BS</creator><creator>Cooper, Lindsay B., BS</creator><creator>Burrows, Whitney, MD</creator><creator>Gamliel, Ziv, MD</creator><creator>Krasna, Mark J., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080201</creationdate><title>Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis</title><author>Kwong, King F., MD ; Hobbs, Jessica L., BS ; Cooper, Lindsay B., BS ; Burrows, Whitney, MD ; Gamliel, Ziv, MD ; Krasna, Mark J., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c512t-5c943bc6e955fbc17c25954c1eb1e9da0dfafae35c15ddb9fc2e2ab3c7a46a293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiothoracic Surgery</topic><topic>Child</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hyperhidrosis - diagnosis</topic><topic>Hyperhidrosis - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Satisfaction</topic><topic>Probability</topic><topic>Quality of Life</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Thoracic Nerves - surgery</topic><topic>Thoracic Surgery, Video-Assisted - methods</topic><topic>Thoracoscopy - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kwong, King F., MD</creatorcontrib><creatorcontrib>Hobbs, Jessica L., BS</creatorcontrib><creatorcontrib>Cooper, Lindsay B., BS</creatorcontrib><creatorcontrib>Burrows, Whitney, MD</creatorcontrib><creatorcontrib>Gamliel, Ziv, MD</creatorcontrib><creatorcontrib>Krasna, Mark J., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kwong, King F., MD</au><au>Hobbs, Jessica L., BS</au><au>Cooper, Lindsay B., BS</au><au>Burrows, Whitney, MD</au><au>Gamliel, Ziv, MD</au><au>Krasna, Mark J., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>85</volume><issue>2</issue><spage>390</spage><epage>394</epage><pages>390-394</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Background The primary goal of this study is to identify clinical variables associated with successful surgical treatment for hyperhidrosis and facial blushing. Methods Six hundred eight thoracoscopic sympathicotomies were performed in 304 patients. Retrospective stratified analysis of patients after thoracoscopic sympathicotomy for hyperhidrosis or facial blushing and having completed follow-up of at least 6 months (n = 232) was performed. Preoperative and postoperative quality-of-life indices (range, 0 to 3) were used to measure impact of surgery, and comparisons were indexed to preoperative symptoms. Postoperative compensatory sweating was analyzed with respect to the level(s) of sympathetic chain division. Results Thoracoscopic sympathicotomy was performed at level T2 alone in 5% of patients; levels T2 to T3 in 63% of patients; levels T3 to T4 in 3% of patients; levels T2 to T4 in 14% of patients; and more than three levels in 14% of patients. In hyperhidrosis patients, mean preoperative quality-of-life index was 2.0 and postoperative quality-of-life index was 0.4 ( p < 0.001). Facial blushers had preoperative and postoperative quality-of-life index of 2.6 and 1.0, respectively. Significant compensatory sweating was seen in 33% patients overall and occurred in 29% of patients with palmar symptoms, 26% of axillary patients, and 42% of facial blushers. Significant compensatory sweating in relation to the level(s) of sympathetic chain division occurred in T2 alone, 45%; T2 to T3, 30%; T3 to T4, 14%; T2 to T4, 38%; and more than three levels, 49%. Conclusions Significant improvement in quality of life can result from surgery for hyperhidrosis. However, the incidence of postoperative compensatory sweating may be dependent on the level of sympathicotomy performed. The choice of sympathicotomy level(s) should be directed toward reducing the incidence of significant compensatory sweating while simultaneously ensuring relief of primary preoperative symptoms.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>18222231</pmid><doi>10.1016/j.athoracsur.2007.08.001</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Cardiothoracic Surgery Child Cohort Studies Female Follow-Up Studies Humans Hyperhidrosis - diagnosis Hyperhidrosis - surgery Male Middle Aged Patient Satisfaction Probability Quality of Life Retrospective Studies Risk Assessment Severity of Illness Index Surgery Thoracic Nerves - surgery Thoracic Surgery, Video-Assisted - methods Thoracoscopy - methods Treatment Outcome |
| title | Stratified Analysis of Clinical Outcomes in Thoracoscopic Sympathicotomy for Hyperhidrosis |
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