Naomi Hirakawa1, Ikuyo Higashimoto2, Ayako Takamori3, Eri Tsukamoto4, Yuhei Uemura5. 1. Department of Pain Clinic & Palliative Care Medicine, Department of the Anesthesiology & Critical Care Medicine, Saga University Hospital, 5-1-1, Nabeshima, Saga, 849-8501, Japan. hirakan@cc.saga-u.ac.jp. 2. Department of Anesthesiology, JCHO Saga Central Hospital, Saga, Japan. 3. Clinical Research Center, Saga University Hospital, Saga, Japan. 4. Department of Pain Clinic & Palliative Care Medicine, Saga University Hospital, 5-1-1, Nabeshima, Saga, 849-8501, Japan. 5. Uemura Pain Clinic, Fukuoka, Japan.
Abstract
PURPOSE: When performing endoscopic thoracic sympathectomy (ETS) in palmar hyperhidrosis patients, a device can be used to measure sweat volume pre- and postoperatively in order to assess indications and treatment effects. In this study, we measured changes in the dynamics of sweating in hyperhidrosis patients pre- and postoperatively and compared the values with those in healthy subjects without hyperhidrosis. METHODS: The patient group comprised 25 persons with palmar hyperhidrosis who were scheduled for ETS. The dynamics of sweating was measured at 1 day prior to surgery and at 2 days postoperatively, in 18 patients at > 1 year postoperatively in another palmar hyperhidrosis group, and in 20 healthy subjects without hyperhidrosis. A device for measuring local sweat volume was applied at the thenar eminence of both palms. Indicators established were basal sweat rate (BSR; mg/min/cm2), peak sweat rate (PSR; mg/min/cm2) during mental stress (sympathetic sweating response), sweat volume (SV), and sweat time (ST; s). RESULTS: After surgery, all of the indicators were significantly reduced in hyperhidrosis patients and there was very little response to mental stress. The subgroup of these patients assessed at > 1 year after ETS showed a trend of increased BSR similar to that of healthy subjects. These changes did not correlate with the extent of the removal surgery. Preoperatively, hyperhidrosis patients had significantly greater BSR, PSR, and SV and longer ST than healthy subjects. CONCLUSION: All of the sweating parameters were increased in palmar hyperhidrosis patients prior to surgery. Immediately after ETS, all these parameters were significantly reduced. At > 1 year after ETS, the BSR had increased to a level similar to that of the healthy volunteers, although PSR did not respond to mental stress.
PURPOSE: When performing endoscopic thoracic sympathectomy (ETS) in palmar hyperhidrosispatients, a device can be used to measure sweat volume pre- and postoperatively in order to assess indications and treatment effects. In this study, we measured changes in the dynamics of sweating in hyperhidrosispatients pre- and postoperatively and compared the values with those in healthy subjects without hyperhidrosis. METHODS: The patient group comprised 25 persons with palmar hyperhidrosis who were scheduled for ETS. The dynamics of sweating was measured at 1 day prior to surgery and at 2 days postoperatively, in 18 patients at > 1 year postoperatively in another palmar hyperhidrosis group, and in 20 healthy subjects without hyperhidrosis. A device for measuring local sweat volume was applied at the thenar eminence of both palms. Indicators established were basal sweat rate (BSR; mg/min/cm2), peak sweat rate (PSR; mg/min/cm2) during mental stress (sympathetic sweating response), sweat volume (SV), and sweat time (ST; s). RESULTS: After surgery, all of the indicators were significantly reduced in hyperhidrosispatients and there was very little response to mental stress. The subgroup of these patients assessed at > 1 year after ETS showed a trend of increased BSR similar to that of healthy subjects. These changes did not correlate with the extent of the removal surgery. Preoperatively, hyperhidrosispatients had significantly greater BSR, PSR, and SV and longer ST than healthy subjects. CONCLUSION: All of the sweating parameters were increased in palmar hyperhidrosispatients prior to surgery. Immediately after ETS, all these parameters were significantly reduced. At > 1 year after ETS, the BSR had increased to a level similar to that of the healthy volunteers, although PSR did not respond to mental stress.
Authors: Augusto Ishy; José Ribas Milanez de Campos; Nelson Wolosker; Paulo Kauffman; Miguel Lia Tedde; Camila Ribeiro Chiavoni; Fábio Biscegli Jatene Journal: Interact Cardiovasc Thorac Surg Date: 2011-01-13
Authors: Robert J Cerfolio; Jose Ribas Milanez De Campos; Ayesha S Bryant; Cliff P Connery; Daniel L Miller; Malcolm M DeCamp; Robert J McKenna; Mark J Krasna Journal: Ann Thorac Surg Date: 2011-05 Impact factor: 4.330