Objective evaluation of plantar hyperhidrosis after sympathectomy

Area of Science:

• Medical research
• Surgical outcomes
• Hyperhidrosis treatment

Background:

• Palmar and plantar hyperhidrosis significantly impact quality of life.
• Video-assisted thoracic sympathectomy (VATS) is a common treatment for palmar hyperhidrosis.

Purpose of the Study:

• To prospectively evaluate the one-year effect of VATS on plantar hyperhidrosis in patients with combined palmar and plantar hyperhidrosis.
• To objectively measure changes in plantar sweating using a sudorometer (VapoMeter).

Main Methods:

• 40 patients with combined palmar and plantar hyperhidrosis underwent VATS (T3 or T4 ganglion).
• Plantar sweating was assessed using a VapoMeter immediately post-operation and during a one-year follow-up.
• Patients were monitored for palmar hyperhidrosis, compensatory hyperhidrosis, and plantar hyperhidrosis severity.

Main Results:

• All patients achieved immediate relief from palmar hyperhidrosis.
• Initial improvement in plantar hyperhidrosis was observed in 46.25% of cases, decreasing to 30% at one year.
• Worsening of plantar hyperhidrosis occurred in 47.50% of patients by one year; 87.5% experienced compensatory hyperhidrosis.

Conclusions:

• VATS provides initial but not sustained improvement in plantar hyperhidrosis for patients with combined hyperhidrosis.
• The effectiveness of VATS for plantar hyperhidrosis diminishes significantly over one year.
• VATS should not be considered for isolated plantar hyperhidrosis due to limited long-term efficacy and potential for compensatory sweating.