Master's and Doctorate Program: Health and Environment, Tiradentes University, Aracaju, Brazil.
Department of Medicine, Tiradentes University, Aracaju, Brazil.
Int J Dermatol. 2019 Aug;58(8):982-986. doi: 10.1111/ijd.14470. Epub 2019 May 17.
On July 25, 2017, we conducted an extensive database tracking to identify all studies published from January 1990 to July 2017. Screening updates were performed until December 2017. RESULTS: There were no deaths, and the resolution of symptoms of primary plantar hyperhidrosis (PPH) occurred in 92% of patients after mechanical sympathectomy. A total of 177 patients (44%) were reported to have mild to severe compensatory sweating after a mean 6 months follow-up. The preservation of L2 did not interfere with the primary outcome, and it is possible to perform lumbar sympathectomy in men with L2 preservation, achieving satisfactory cure results of PPH, minimizing the risk of sexual dysfunction. There were no deaths, and the resolution of symptoms of PPH occurred in 10% of patients after chemical sympathicolysis after a mean 6 months follow-up. A total of 13 patients (12.5%) were reported to have mild to severe compensatory sweating using the same technique. CONCLUSION: The mechanical lumbar sympathectomy is effective and safe and improves quality of life, evaluated by the high symptom resolution of PPH and low rate of complications. The chemical sympathicolysis in the immediate postoperative period presented satisfactory results; however, it was shown to be significantly less effective than the mechanical approach in a follow-up of at least 6 months.
2017 年 7 月 25 日，我们进行了广泛的数据库追踪，以确定从 1990 年 1 月至 2017 年 7 月发表的所有研究。截至 2017 年 12 月，我们对更新结果进行了筛选。结果：没有死亡病例，92%的原发性足底多汗症（PPH）患者在接受机械交感神经切除术治疗后症状得到缓解。平均随访 6 个月后，有 177 例（44%）患者报告出现轻度至重度代偿性出汗。保留 L2 并不影响主要结果，在保留 L2 的情况下，男性也可以进行腰椎交感神经切除术，从而达到 PPH 的满意治愈效果，最大限度地降低性功能障碍的风险。化学交感神经溶解术后平均 6 个月的随访中，10%的患者 PPH 症状缓解，没有死亡病例。采用相同技术，有 13 例（12.5%）患者报告出现轻度至重度代偿性出汗。结论：机械性腰椎交感神经切除术安全有效，可提高 PPH 症状的缓解率，降低并发症发生率，从而提高生活质量。术后即刻的化学交感神经溶解术结果令人满意，但至少 6 个月的随访显示，其效果明显低于机械性手术。
