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Video-assisted sympathectomy for essential hyperhidrosis: effects on cardiopulmonary function.
Laura Vigil1, Nuria Calaf, Esperança Codina
1Department of Medicine, Autonomous University of Barcelona, [corrected] Spain. lvigil@hsp.santpau.es
Chest
|October 21, 2005
Summary
Video-assisted sympathectomy for essential hyperhidrosis is safe, with minimal impact on cardiopulmonary function. Minor airway changes and heart rate effects were observed but deemed clinically insignificant.
Area of Science:
- Cardiopulmonary Physiology
- Thoracic Surgery
- Sympathetic Nervous System
Background:
- Essential hyperhidrosis involves sympathetic overactivity via upper-dorsal ganglia (D2-D3).
- Video-assisted thoracoscopy sympathectomy is the primary treatment.
- Potential cardiopulmonary function alterations post-surgery are a concern.
Purpose of the Study:
- To evaluate cardiopulmonary function impairment following sympathectomy in essential hyperhidrosis patients.
Main Methods:
- Prospective controlled trial involving 20 essential hyperhidrosis patients.
- Pulmonary function tests (spirometry, thoracic gas volume, bronchial challenge, maximal exercise) conducted pre- and post-surgery.
- Video-assisted thoracoscopy with D2-D3 ganglia electrocoagulation performed bilaterally.
Main Results:
- No significant changes in spirometry or lung volumes.
- Maximal midexpiratory flow showed a statistically significant decrease (p < 0.05).
- Bronchial hyperresponsiveness persisted or developed in some patients; maximal exercise revealed reduced heart rate and gas uptake.
Conclusions:
- Video-assisted thoracoscopy is a safe treatment for essential hyperhidrosis.
- Observed cardiopulmonary changes suggest minor small airway alterations and mild heart rate sympathetic blockade.
- The clinical significance of these findings is considered minimal.