Original Articles
Results of High Bilateral Endoscopic Thoracic Sympathectomy and Sympatholysis in the Treatment of Primary Hyperhidrosis: a Study of 1016 Procedures
J. Moyaa,b,
, R. Ramosa,b, R. Moreraa, R. Villalongac, V. Pernaa, I. Maciaa, G. Ferrera
Corresponding author
jmoya@ub.edu
Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. FeixaLlarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. FeixaLlarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España
a Servicio de Cirugía Torácica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
b Departament de Patologia i Terapèutica Experimental, Facultat de Medicina, Universidad de Barcelona, Barcelona, Spain
c Servicio de Anestesiología y Reanimación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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"apellidos" => "Moya" "email" => array:1 [ 0 => "jmoya@ub.edu" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Ramos" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Morera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "R." 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"apellidos" => "Ferrer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Torácica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departament de Patologia i Terapèutica Experimental, Facultat de Medicina, Universidad de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Anestesiología y Reanimación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. J. Moya. Servicio de Cirugía Torácica. Hospital Universitari de Bellvitge. FeixaLlarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-07-20" "fechaAceptado" => "2005-10-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154340" "palabras" => array:4 [ 0 => "Endoscopic thoracic sympathectomy" 1 => "Hyperhidrosis" 2 => "Hemothorax" 3 => "Compensatory hyperhidrosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154339" "palabras" => array:4 [ 0 => "Simpatectomía torácica endoscópica" 1 => "Hiperhidrosis" 2 => "Hemotórax" 3 => "Hiperhidrosis compensadora" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Thoracic sympatholysis and sympathectomy are the current standard treatments for primary hyperhidrosis. In this study, we evaluated the incidence of peri-and postoperative complications associated with these procedures.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">From 1996 to 2004,520 consecutive patients (364 women), with a mean age of 26.8 years, were treated for primary hyperhidrosis at our hospital. The procedure was bilateral in all but 24 cases. The 484 patients in the sympatholysis group underwent a single intervention while the 36 patients in the sympathectomy group underwent 2 separate interventions.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">NO deaths occurred. Anhidrosis of the target area was achieved in 97.6% of patients while 2.2% experienced hypohidrosis. In 0.2% of the cases, the procedure was initially unsuccessful and a second intervention was required. The mean duration of hospital stay was 72 hours for patients in the sympathectomy group and 17 hours for the sympatholysis group. Serious intraoperative complications requiring conversion to thoracotomy were recorded in 0.2% of patients. Postoperative complications—of which pneumothorax was the most common—occurred in 5.2% of the cases (in 22.5% of the sympathectomy group and 3.55% of the sympatholysis group). Compensatory hyperhidrosis occurred in 48.4% of the patients, excessive dryness of the hands and palpebral ptosis in 0.38%, and gustatory sweating in 0.9%. The degree of patient satisfaction was quite high (88.5%) and only 2.3% were very unsatisfied.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Given the results obtained, we can conclude that both sympatholysis and sympathectomy are appropriate treatments for hyperhidrosis. Nonetheless, because sympatholysis is both easier to perform and less aggressive, we consider it the treatment of choice for primary hyperhidrosis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La simpaticolisis y la simpatectomía torácica son actualmente los tratamientos habituales de la hiperhidrosis primaria. En este estudio evaluamos la incidencia cuantitativa y cualitativa de las complicaciones peri y postoperatorias.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Desde 1996 a 2004 se intervino consecutivamente a 520 pacientes (364 mujeres) con hiperhidrosis primaria, con una edad media de 26,8 años. En todos, excepto en 24 casos, el procedimiento fue bilateral. La inter-vención se realizó en un tiempo en 484 pacientes (simpaticólisis) y en 2 tiempos en 36 (simpatectomía).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">NO hubo mortalidad. La anhidrosis del te-rritorio deseado fue del 97,6 %, se apreció hipohidrosis en el 2,2% y hubo un 0,2% de fallos que requirieron reinterven-ción. La estancia media fue de 72 h en el grupo de simpatectomía y de 17 h en el de simpaticólisis. Se registró un 0,2% de complicaciones intraoperatorias mayores con reconversión a toracotomía. Se produjo un 5,2% de complicaciones postoperatorias (un 22,5% en las simpatectomías y un 3,55% en la simpaticólisis), de las cuales el neumotórax fue la más frecuente. Se observó hiperhidrosis compensadora en un 48,4% de los casos, sequedad excesiva de manos y ptosis palpebral en el 0,38%, e hiperhidrosis gustativa en un 0,9% de casos. El grado de satisfacción fue muy elevado (88,5%) y sólo un 2,3% de los pacientes se manifestaron muy insatisfe-chos.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">De los resultados obtenidos se deduce que tanto la simpaticolisis como la simpatectomía son tratamientos adecuados de la hiperhidrosis, si bien la mayor sencillez y menor agresividad de la primera nos llevan a considerarla el tratamiento de elección en la hiperhidrosis primaria.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hiperhidrosis primaria: estudio prospectivo de 338 pacientes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R Ramos" 1 => "J Moya" 2 => "J Pérez" 3 => "R Villalonga" 4 => "R Morera" 5 => "R Pujol" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 0 | 1 | 1 |
| 2024 October | 25 | 20 | 45 |
| 2024 September | 23 | 16 | 39 |
| 2024 August | 31 | 27 | 58 |
| 2024 July | 24 | 27 | 51 |
| 2024 June | 23 | 22 | 45 |
| 2024 May | 31 | 31 | 62 |
| 2024 April | 23 | 28 | 51 |
| 2024 March | 19 | 17 | 36 |
| 2024 February | 15 | 18 | 33 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 17 | 15 | 32 |
| 2023 January | 16 | 26 | 42 |
| 2022 December | 27 | 24 | 51 |
| 2022 November | 18 | 16 | 34 |
| 2022 October | 25 | 28 | 53 |
| 2022 September | 14 | 24 | 38 |
| 2022 August | 20 | 30 | 50 |
| 2022 July | 24 | 37 | 61 |
| 2022 June | 17 | 26 | 43 |
| 2022 May | 17 | 23 | 40 |
| 2022 April | 19 | 25 | 44 |
| 2022 March | 24 | 29 | 53 |
| 2022 February | 18 | 24 | 42 |
| 2022 January | 17 | 29 | 46 |
| 2021 December | 21 | 50 | 71 |
| 2021 November | 14 | 57 | 71 |
| 2021 October | 18 | 46 | 64 |
| 2021 September | 19 | 52 | 71 |
| 2021 August | 13 | 32 | 45 |
| 2021 July | 11 | 28 | 39 |
| 2021 June | 11 | 37 | 48 |
| 2021 May | 46 | 18 | 64 |
| 2021 April | 105 | 74 | 179 |
| 2021 March | 20 | 24 | 44 |
| 2021 February | 10 | 18 | 28 |
| 2021 January | 12 | 18 | 30 |
| 2020 December | 10 | 18 | 28 |
| 2020 November | 13 | 11 | 24 |
| 2020 October | 11 | 10 | 21 |
| 2020 September | 14 | 7 | 21 |
| 2020 August | 12 | 13 | 25 |
| 2020 July | 20 | 21 | 41 |
| 2020 June | 8 | 3 | 11 |
| 2020 May | 24 | 22 | 46 |
| 2020 April | 18 | 25 | 43 |
| 2020 March | 13 | 11 | 24 |
| 2020 February | 17 | 19 | 36 |
| 2020 January | 21 | 18 | 39 |
| 2019 December | 12 | 16 | 28 |
| 2019 November | 12 | 12 | 24 |
| 2019 October | 7 | 7 | 14 |
| 2019 September | 3 | 8 | 11 |
| 2019 August | 9 | 11 | 20 |
| 2019 July | 10 | 15 | 25 |
| 2019 June | 7 | 7 | 14 |
| 2019 May | 7 | 10 | 17 |
| 2019 April | 10 | 48 | 58 |
| 2019 March | 5 | 19 | 24 |
| 2019 February | 6 | 8 | 14 |
| 2019 January | 4 | 10 | 14 |
| 2018 December | 8 | 10 | 18 |
| 2018 November | 9 | 14 | 23 |
| 2018 October | 15 | 17 | 32 |
| 2018 September | 8 | 8 | 16 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 5 | 6 | 11 |
| 2018 March | 7 | 9 | 16 |
| 2018 February | 4 | 7 | 11 |
| 2018 January | 7 | 6 | 13 |
| 2017 December | 10 | 10 | 20 |
| 2017 November | 6 | 5 | 11 |
| 2017 October | 5 | 15 | 20 |
| 2017 September | 8 | 5 | 13 |
| 2017 August | 6 | 13 | 19 |
| 2017 July | 8 | 11 | 19 |
| 2017 June | 7 | 10 | 17 |
| 2017 May | 4 | 10 | 14 |
| 2017 April | 3 | 5 | 8 |
| 2017 March | 1 | 6 | 7 |
| 2017 February | 0 | 1 | 1 |
| 2017 January | 2 | 7 | 9 |
| 2016 December | 8 | 10 | 18 |
| 2016 November | 12 | 6 | 18 |
| 2016 October | 20 | 7 | 27 |
| 2016 September | 11 | 3 | 14 |
| 2016 August | 6 | 2 | 8 |
| 2016 July | 6 | 0 | 6 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 46 | 9 | 55 |
| 2015 September | 50 | 6 | 56 |
| 2015 August | 46 | 12 | 58 |
| 2015 July | 45 | 5 | 50 |
| 2015 June | 31 | 3 | 34 |
| 2015 May | 41 | 8 | 49 |
| 2015 April | 30 | 9 | 39 |
| 2015 March | 41 | 12 | 53 |
| 2015 February | 27 | 1 | 28 |
| 2015 January | 45 | 6 | 51 |
| 2014 December | 38 | 5 | 43 |
| 2014 November | 39 | 4 | 43 |
| 2014 October | 57 | 11 | 68 |
| 2014 September | 57 | 5 | 62 |
| 2014 August | 39 | 9 | 48 |
| 2014 July | 39 | 6 | 45 |
| 2014 June | 47 | 8 | 55 |
| 2014 May | 48 | 13 | 61 |
| 2014 April | 58 | 6 | 64 |
| 2014 March | 54 | 10 | 64 |
| 2014 February | 45 | 12 | 57 |
| 2014 January | 36 | 7 | 43 |
| 2013 December | 37 | 12 | 49 |
| 2013 November | 35 | 5 | 40 |
| 2013 October | 39 | 10 | 49 |
| 2013 September | 46 | 8 | 54 |
| 2013 August | 35 | 8 | 43 |
| 2013 July | 52 | 9 | 61 |
| 2013 June | 38 | 8 | 46 |
| 2013 May | 30 | 3 | 33 |
| 2013 April | 21 | 4 | 25 |
| 2013 March | 9 | 1 | 10 |
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