Faustino Carolina B, Milanez de Campos Jose Ribas, Kauffman Paulo, Leiderman Dafne Diamante, Tedde Miguel, Cucato Gabriel, Fernandes Paulo P, Leão Pedro P, Wolosker Nelson
Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Division of Thoracic Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil; Thoracic Surgery Division, Department of Surgery, University of São Paulo School of Medicine, São Paulo, Brazil.
Ann Vasc Surg. 2020 May;65:107-112. doi: 10.1016/j.avsg.2019.04.024. Epub 2019 Sep 5.
Several factors that could influence the efficacy and satisfaction of patients after bilateral thoracic sympathectomy (video-assisted thoracoscopic sympathectomy [VATS]) in the treatment of hyperhidrosis (HH) have been studied, but no studies in the literature have specifically analyzed the effectiveness of treatment and variations in the quality of life of patients aged 40 years or older compared with those of young adult patients (19-40 years).
We retrospectively analyzed 2,431 HH patients who underwent bilateral VATS and divided the patients into the following groups: a group younger than 40 years old (1,760 patients) and a group 40 years and older (142 patients). Variables included quality of life before surgery, improvement in quality of life after surgery, clinical improvement in sweating, the presence of severe compensatory hyperhidrosis (CH), and general satisfaction at 1 month after surgery.
We observed that all surgical patients presented with poor or very poor quality of life before surgery, with similar proportions in both groups. In the postoperative period, we observed improvement in quality of life in more than 90% of the patients, with no significant difference noted between the 2 groups of patients. More than 90% of the patients in this series had great clinical improvement in the main HH site, with no significant difference between the 2 groups. Severe CH occurred in 23.8% of the patients in this series, with no significant difference between the 2 groups.
Patients 40 years of age or older benefit just as much as younger patients from VATS performed to treat primary HH, presenting excellent significant surgical results.
已经研究了几种可能影响双侧胸交感神经切除术（电视辅助胸腔镜交感神经切除术[VATS]）治疗多汗症（HH）后患者疗效和满意度的因素，但文献中没有研究专门分析40岁及以上患者与年轻成年患者（19 - 40岁）相比的治疗效果和生活质量变化。
我们回顾性分析了2431例行双侧VATS的HH患者，并将患者分为以下几组：年龄小于40岁的一组（1760例患者）和40岁及以上的一组（142例患者）。变量包括手术前的生活质量、手术后生活质量的改善、出汗的临床改善、严重代偿性多汗症（CH）的存在以及手术后1个月的总体满意度。
我们观察到所有手术患者术前生活质量均较差或非常差，两组比例相似。在术后期间，我们观察到超过90%的患者生活质量有所改善，两组患者之间无显著差异。本系列中超过90%的患者主要HH部位有显著临床改善，两组之间无显著差异。本系列中23.8%的患者发生严重CH，两组之间无显著差异。
40岁及以上的患者与年轻患者一样，从用于治疗原发性HH的VATS中获益，手术效果极佳且显著。
