Giudiceandrea A. +, Tarfusser I. **, Cosio R. *
*Policinico San Donato, reparto di chirurgia III, Milano, **Casa di Cura S. Anna, Merano, +Istituto clinico S. Anna, anestesia e rianimazione, Brescia, Italy
The Eighth International Symposium on Sympathetic Surgery (ISSS) and VATS, 25 to 29 March 2009, New York, United States
Objective: Endoscopic sympathectomy is an effective way to treat different types of hyperhidrosis, but the procedure often leads to increased sweating in other areas (mainly trunk and legs). Compensatory sweating (CS) following interruption of the lumbar sympathetic trunk for the treatment of plantar hyperhidrosis may vary from barely perceptible to relatively intense. The aim of the study was to investigate the parameters influencing the degree of CS in patients operated for plantar hyperhidrosis with retroperitoneoscopic lumbar sympathectomy.
Materials and methods: A total of 20 patient were operated in Italy between April 2007 and December 2008. Mean age was 35.2 years ? 6. 15 (75%) females, 5 (25%) males. 15 individuals (75%) had undergone previous thoracic sympathectomy for palmar hyperhidrosis (ETS). All patients underwent retroperitoneoscopic lumbar sympathectomy bilaterally in one single procedure. The sympathetic trunk was clipped around the 3rd and 4th lumbar ganglion. As part of the follow-up, each patients returned a simple questionnaire, reporting the level of CS on a visual analogue scale (0 to 5).
Results: Mean follow-up was 7.45 ± 4.5 months. Preoperatively, the mean level of truncal sweating was 3.0 ± 0.5; postoperatively, the mean CS was 3.5 ± 0.3. Multivariate analysis with a logistic regression model showed that “lumbar sympathectomy alone” and “male sex” were predictors for increased CS, whereas no significant additional CS was reported by patients that had undergone thoracic sympathectomy at an earlier stage.