Friday, September 23, 2011

A revealing published medical study on compensatory sweating after ETS (46 patients studied)

Below you can read the abstract (summary) of a study done in the United Kingdom and published earlier this year in the International Journal of Surgery. The study was also presented previously to the Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland, Glasgow, UK (13th–15th May 2009).

Here is the link to the study's online abstract:
http://www.sciencedirect.com/science/article/pii/S1743919111000720

An analysis of the natural course of compensatory sweating following thoracoscopic sympathectomy

A.C. Currieb, J.R. Evansa, P.R.S. Thomasa

Department of Surgery, Epsom and St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, United Kingdom

Department of Surgery, Division of Surgery and Cancer, Imperial College, London W2 1NY, United Kingdom

Received 28 March 2011; revised 12 April 2011; Accepted 13 April 2011. Available online 22 April 2011.

Abstract

Background
To evaluate the long-term results of thoracoscopic sympathectomy in the treatment of hyperhydrosis.

Methods
Theatre log books were used to identify all patients who underwent thoracoscopic sympathectomy between 2000 and 2006. Details of pre-operative symptoms, surgical procedure and post-operative complications were collected from the patient notes. Each patient was sent a questionnaire regarding success of the procedure, compensatory sweating and overall satisfaction.

Results
46 hyperhydrosis patients (34 females) age range 14–57 years. 20 patients suffered with hyperhydrosis in a combination of areas, 14 in the axillae alone, 9 palms alone and with 2 facial symptoms. There were 2 early post-operative complications, 1 haemothorax which required a chest drain and a chest infection. 3 patients required redo procedures. Of follow-up of 42 months (range 6–84), 32 (69·5%) patients reported complete dryness or a significant improvement in symptoms and 15 a substantial improvement in quality of life.

However, 43 patients (93%) suffered with compensatory sweating, of these 27 had to change clothes more than once daily. Compensatory sweating was graded as severe in 18 and incapacitating in 2.

Of note only 5 patients noticed an improvement in the compensatory sweating over time.

Only 26 (56%) would recommend thoracoscopic sympathectomy to others with hyperhydrosis.

Conclusion
Thoracoscopic sympathectomy is effective in the treatment of hyperhydrosis. However, compensatory sweating seems unavoidable and infrequently improves with time. Patients need to be carefully counselled before committing to surgery.

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While this is but one study, it would be fair to say this is just one of many published studies on the side effects of ETS that shows ETS surgeons frequently do not reveal the true risks of the surgery to patients before they have the procedure.

Most ETS surgeons tell their prospective patients that the chance of developing compensatory sweating is around 1%, and that if compensatory sweating is experienced by the patient post-ETS, it will be 'mild' or 'just a little bit of sweating on your back or stomach'.

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