초록접수 현황
| 19F-264 | 구연 발표 |
Surgical Treatment of Compensatory Hyperhidrosis
Kwanyong Hyun, Jae Kil Park, Mi Hyoung Moon, Ji Yoon Lee, Jungsun Lee
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
Purpose : Compensatory hyperhidrosis (CH) is a debilitating condition occurring in 30%–90% of patients with primary hyperhidrosis, postoperatively. The most appropriate treatment for this condition remains controversial.
Methods : Clinical data from 37 patients with intractable CH (25 male, 12 female; median age, 31 years) who underwent reoperative sympathetic surgery between January 2018 and May 2019 were reviewed. The method of operation was initially multilevel thoracic sympathicotomy (extended diffuse sympathicotomy, EDS). Levels of surgical interruption were modified in December 2018, to maximize sympatholytic effects (more extended diffuse sympathicotomy, MEDS). All patients were followed up and evaluated for symptom resolution.
Results : Diffuse sympathicotomy was performed as EDS (n=29) and MEDS (n=8). Immediate resolution of CH was achieved in 77% of patients, as determined at the 1–2 week postoperative visit. With a median follow up of 11.7 months, CH continued to be tolerable in 12 patients (32%) and recurred in 25 patients (68%). Recurrence of CH was more common in patients who underwent diffuse sympathicotomy and lumbar sympathectomy simultaneously than in patients who underwent diffuse sympathicotomy alone (100% vs. 61%; p=0.168). CH recurrence rates were 79% and 25% in the EDS and MEDS groups, respectively(p=0.013), indicating that MEDS could be a promising approach for controlling CH. No patients experienced surgery-related side effects during the follow-up period. Digital infrared thermographic images obtained before and after surgery in 3 patients also showed successful denervation and sweat diminishment.
Conclusion : Diffuse sympathicotomy is safe and effective for controlling CH. A reoperative approach could be actively considered as a treatment option for CH.
Methods : Clinical data from 37 patients with intractable CH (25 male, 12 female; median age, 31 years) who underwent reoperative sympathetic surgery between January 2018 and May 2019 were reviewed. The method of operation was initially multilevel thoracic sympathicotomy (extended diffuse sympathicotomy, EDS). Levels of surgical interruption were modified in December 2018, to maximize sympatholytic effects (more extended diffuse sympathicotomy, MEDS). All patients were followed up and evaluated for symptom resolution.
Results : Diffuse sympathicotomy was performed as EDS (n=29) and MEDS (n=8). Immediate resolution of CH was achieved in 77% of patients, as determined at the 1–2 week postoperative visit. With a median follow up of 11.7 months, CH continued to be tolerable in 12 patients (32%) and recurred in 25 patients (68%). Recurrence of CH was more common in patients who underwent diffuse sympathicotomy and lumbar sympathectomy simultaneously than in patients who underwent diffuse sympathicotomy alone (100% vs. 61%; p=0.168). CH recurrence rates were 79% and 25% in the EDS and MEDS groups, respectively(p=0.013), indicating that MEDS could be a promising approach for controlling CH. No patients experienced surgery-related side effects during the follow-up period. Digital infrared thermographic images obtained before and after surgery in 3 patients also showed successful denervation and sweat diminishment.
Conclusion : Diffuse sympathicotomy is safe and effective for controlling CH. A reoperative approach could be actively considered as a treatment option for CH.
책임저자: Jae Kil Park
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
발표자: Kwanyong Hyun, E-mail : pipedragon@gmail.com