Bilateral one-stage single-port sympathicotomy in primary focal hyperhidrosis, a prospective cohort study: treat earlier?

Autor: Wobbe Bouma, Theo J. Klinkenberg, Michiel Kuijpers, Petra W. Harms, Massimo A. Mariani, Mike J. L. DeJongste, Gwen Peeters
Přispěvatelé: Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
medicine.medical_treatment
030207 dermatology & venereal diseases
0302 clinical medicine
Quality of life
Surveys and Questionnaires
Postoperative Period
Prospective Studies
Prospective cohort study
Sympathicotomy
Hyperhidrosis
Palmar
General Medicine
Middle Aged
Cardiac surgery
Treatment Outcome
Patient Satisfaction
Cardiothoracic surgery
030220 oncology & carcinogenesis
Female
Patient Safety
medicine.symptom
Cardiology and Cardiovascular Medicine
Algorithms
Research Article
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Adolescent
lcsh:Surgery
Sweating
VATS
lcsh:RD78.3-87.3
03 medical and health sciences
medicine
Humans
Sympathectomy
business.industry
Endoscopic thoracic sympathectomy
Compensatory hyperhidrosis
Endoscopy
lcsh:RD1-811
Surgery
lcsh:Anesthesiology
Axilla
Quality of Life
Single-port
business
Zdroj: Journal of Cardiothoracic Surgery, Vol 16, Iss 1, Pp 1-7 (2021)
Journal of cardiothoracic surgery, 16(1):50. BMC
Journal of Cardiothoracic Surgery
ISSN: 1749-8090
Popis: Background Primary Focal Hyperhidrosis (PFH) has a detrimental effect on Quality of Life. Repetitive, non-curative symptomatic strategies dominate current treatment of PFH, in spite of the availability of an effective and permanent curative treatment like Endoscopic Thoracic Sympathectomy (ETS). Current surgical optimization may allow for a re-established position of sympathetic modulation in this treatment algorithm. We sought to evaluate the safety, effectiveness, and long-term results of a Bilateral One-stage Single-port Sympathicotomy (BOSS) procedure in PFH patients and to identify subgroups benefitting most. Methods Prospective analysis of 163 patients, 35 (21.5%) underwent Rib-3 (R3) BOSS for palmar PFH, 58 (35.6%) R3-R5 BOSS for axillary PFH and 70 (42.9%) R3-R5 BOSS for combined palmar/axillary PFH. Effectiveness was measured using Skindex-29 and the Hyperhidrosis Disease Severity Scale (HDSS). Results Overall Skindex-29-rating (46.5 ± 14.8 preoperatively vs 20.1 ± 20.6 postoperatively, p p p = 0.004) and in terms of severe compensatory hyperhidrosis, a frequently reported side-effect (17.1% vs 32.8% respectively, p Conclusions BOSS is safe, effective, and offers a long-term curative solution in the treatment of PFH. Especially in the palmar PFH subgroup, R3 BOSS treatment results compare favorably to the treatment results of non-curative alternatives published in the current literature. Therefore, R3 BOSS should be offered to all patients with severe PFH, reporting insufficient benefit of treatment options such as oral and/or local agents.
Databáze: OpenAIRE
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