Journal of Korean Neurosurgical Society
- Volume 30 Issue 4
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- Pages.486-492
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- 2001
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
Compensatory Hyperhidrosis after Thoracoscopic Sympathectomy in Essential Hyperhidrosis
본태성 다한증 환자의 수술 후 발생하는 보상성 다한증
- Seo, Eui Kyo (Department of Neurosurgery, Yonsei University College of Medicine) ;
- Cho, Yong Eun (Department of Neurosurgery, Yonsei University College of Medicine) ;
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Yoon, Do Heum
(Department of Neurosurgery, Yonsei University College of Medicine) ;
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Kim, Young Soo
(Department of Neurosurgery, Yonsei University College of Medicine)
- 서의교 (연세대학교 의과대학 신경외과학교실) ;
- 조용은 (연세대학교 의과대학 신경외과학교실) ;
-
윤도흠
(연세대학교 의과대학 신경외과학교실) ;
-
김영수
(연세대학교 의과대학 신경외과학교실)
- Received : 2000.12.04
- Accepted : 2001.02.20
- Published : 2001.04.28
Abstract
Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.