Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients

Nelson Wolosker; Carolina Brito Faustino; Jose Ribas Milanez de Campos; Paulo Kauffman; Guilherme Yazbek; Paulo Pêgo Fernandes; Gabriel Cucato

doi:10.1016/j.jpedsurg.2019.11.004

Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients

J Pediatr Surg. 2020 Mar;55(3):418-424. doi: 10.1016/j.jpedsurg.2019.11.004. Epub 2020 Jan 23.

Authors

Nelson Wolosker¹, Carolina Brito Faustino², Jose Ribas Milanez de Campos³, Paulo Kauffman¹, Guilherme Yazbek⁴, Paulo Pêgo Fernandes⁵, Gabriel Cucato¹

Affiliations

¹ Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein.
² Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein. Electronic address: carolfaus@gmail.com.
³ Division of Thoracic Surgery, Hospital Israelita Albert Einstein; Department of Surgery, Thoracic Surgery Division, University of São Paulo School of Medicine.
⁴ Department of Vascular and Endovascular Surgery, A.C. Camargo Cancer Center, Fundação Antônio Prudente.
⁵ Department of Surgery, Thoracic Surgery Division, University of São Paulo School of Medicine.

PMID: 32063368
DOI: 10.1016/j.jpedsurg.2019.11.004

Abstract

Objective: Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (VATS) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of adolescents patients compared to those of adult patients (18-40 years).

Methods: We retrospectively analyzed 2431 hyperhidrosis patients who underwent bilateral VATS and divided the patients into the following groups: adolescents (472 patients) and adult group (1760 patients). Variables included quality of life prior to surgery, improvement in quality of life after surgery, clinical improvement in sweating, presence of severe compensatory hyperhidrosis and general satisfaction at one month after surgery.

Results: We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the two groups of patients. We observed that all patients undergoing surgery presented poor or very poor quality of life before surgery; however, the two groups were statistically different. The quality of life of the ADOLESCENT group before surgery was statistically worse than that of the ADULT group. More than 90% of the patients in this series had great clinical improvement in the main hyperhidrosis site, with no significant difference between the two groups. Severe compensatory hyperhidrosis occurred in 23.8% of the patients in this series, with no significant difference between the two groups.

Conclusions: Adolescent patients benefit just as much as adult patients from VATS performed to treat primary hyperhidrosis, presenting excellent, significant surgical results.

Type of study: Clinical research.

Levels of evidence: Level III.

Keywords: Adolescents; Hyperhidrosis; Thoracic sympathectomy; VATS; Vascular.

Publication types

Comparative Study

MeSH terms

Adolescent
Humans
Hyperhidrosis / surgery*
Patient Satisfaction
Postoperative Complications
Quality of Life
Retrospective Studies
Sympathectomy* / adverse effects
Sympathectomy* / methods
Sympathectomy* / statistics & numerical data
Thoracic Surgery, Video-Assisted* / adverse effects
Thoracic Surgery, Video-Assisted* / methods
Thoracic Surgery, Video-Assisted* / statistics & numerical data