Ureña Anna, Grando Leandro, Rodriguez-Gussinyer Lluisa, Macía Ivan, Rivas Francisco, Quiroga Nestor Iván, Moreno Camilo, Michavilla Xavier, Ramos Ricard
Department of Thoracic Surgery, Hospital Clinic of Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi i Sunyer-IDIBAPS, 08036 Barcelona, Spain.
J Clin Med. 2025 Jul 8;14(14):4831. doi: 10.3390/jcm14144831.
Primary focal hyperhidrosis, characterized by excessive sweating primarily affecting the hands and axillae, can significantly impact quality of life. Bilateral thoracic sympathectomy is the gold standard treatment, providing permanent resolution of palmar hyperhidrosis. Most studies evaluating outcomes and patient satisfaction after sympathectomy focus on short- to medium-term follow-up, typically up to 5 years. This study aimed to assess anxiety, satisfaction, and sweat redistribution 20 years after bilateral endoscopic thoracic sympathectomy. : Between January 2002 and December 2003, 106 patients with primary hyperhidrosis underwent bilateral endoscopic thoracic sympathectomy targeting ganglia T2-T3 at our center. The patients were contacted via telephone in 2023 and asked to complete the same survey they had filled out preoperatively and 12 months postoperatively. The survey evaluated sweat redistribution, anxiety, hyperhidrosis-related symptoms, and satisfaction. Anxiety, satisfaction, and perceived sweating were rated using a 5-point visual analog scale (VAS) ranging from 0 (unsatisfied/no symptoms) to 4 (very satisfied/severe symptoms). : Of the 106 eligible patients, 24 (22.6%) completed the survey. Most reported persistent anhidrosis (palmar or palmar-axillary) 20 years post-surgery. The survey results remained consistent with those at the 1-year follow-up. Significant sweat redistribution to the abdomen and back was observed. Patient satisfaction remained high, with no significant differences between the 1-year and 20-year assessments. Anxiety significantly decreased compared to preoperative levels ( < 0.001). : Bilateral endoscopic thoracic sympathectomy is an effective long-term treatment for reducing excessive sweating. Patient satisfaction remains high over time, despite the persistence of compensatory sweating.
原发性局灶性多汗症主要表现为手部和腋窝过度出汗，会显著影响生活质量。双侧胸交感神经切除术是金标准治疗方法，可永久性解决手掌多汗症。大多数评估交感神经切除术后结果和患者满意度的研究集中在短期至中期随访，通常长达5年。本研究旨在评估双侧内镜胸交感神经切除术后20年的焦虑、满意度和汗液重新分布情况。2002年1月至2003年12月，106例原发性多汗症患者在我们中心接受了针对T2 - T3神经节的双侧内镜胸交感神经切除术。2023年通过电话联系患者，要求他们完成术前和术后12个月填写的相同调查问卷。该问卷评估了汗液重新分布、焦虑、多汗症相关症状和满意度。焦虑、满意度和感知出汗情况使用5分视觉模拟量表（VAS）进行评分，范围从0（不满意/无症状）到4（非常满意/严重症状）。在106例符合条件的患者中，24例（22.6%）完成了调查。大多数患者报告术后20年仍持续无汗（手掌或手掌 - 腋窝）。调查结果与1年随访时一致。观察到汗液明显重新分布到腹部和背部。患者满意度仍然很高，1年和20年评估之间无显著差异。与术前水平相比，焦虑显著降低（<0.001）。双侧内镜胸交感神经切除术是减少多汗症的一种有效的长期治疗方法。尽管存在代偿性出汗，但随着时间推移患者满意度仍然很高。
