Long term outcome of Video-Assisted Thoracoscopic Sympathectomy at thoracic level (R2-3) versus (R2-4) on Plantar Hyperhidrosis associated with Primary Palmar Hyperhidrosis | ||||
| SVU-International Journal of Medical Sciences | ||||
| Article 67, Volume 7, Issue 2, July 2024, Page 742-752 PDF (462.64 K) | ||||
| Document Type: Original research articles | ||||
| DOI: 10.21608/svuijm.2024.328817.1995 | ||||
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| Authors | ||||
Ahmed Mohamed El-Azazy   ; Mounir Mohamed Zeerban; Abdel Meguid Mohamed Ramadan Momen; Walid Salah Abu Arab
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| Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt. | ||||
| Abstract | ||||
| Background: Hyperhidrosis is unnecessary sweating afar the body needs for cooling down the body temperature. It affects nearly 2-3% of the population with equal gender predominance. Both medical and surgical interventions have been utilized to treat primary hyperhidrosis. Over 80% of patients with palmar hyperhidrosis (PH) also experience plantar hyperhidrosis (PLH). An interesting observation in surgically treated patients with PH is that PLH symptoms tend to decrease after undergoing Video-assisted thoracoscopic surgery (VATS). Objectives: The aim of the present study was to evaluate the efficacy, safety and drawbacks of VATS sympathectomy at thoracic levels (R2-3) versus (R2-4) on PLH associated with primary PH. Patients and methods: this single center, parallel randomized controlled study involved 72 eligible patients presented with primary palmoplantar hyperhidrosis, where 36 patients underwent VATS sympathectomy at thoracic levels R2-3 (Group A) versus other 36 patients at thoracic level R2-4 (Group B). Both groups underwent bilateral two-port tubeless VATS sympathectomy with the use of electrocautery under general anesthesia in semi-fowler position. Results: Following surgery, both groups showed improvement in PLH, but group B had a significantly higher incidence of improvement compared to group A. In group A, 77.7% of patients were satisfied, while in group B, 88.8% of patients reported satisfaction. Conclusion: VATS sympathectomy is the preferred treatment for effectively curing PH. There is a significant correlation between VATS sympathectomy performed at the R2 to R4 levels and the alleviation of PLH. | ||||
| Keywords | ||||
| Palmar hyperhidrosis; Plantar hyperhidrosis; VATS, Sympathectomy | ||||
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