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An Unusual case of excessive sweating affecting the right upper limb after bilateral endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: recurrence or compensatory hyperhidrosis?

Paliogiannis, Panagiotis and Marrosu, Antonio and Attene, Federico and Trignano, Mario and Scognamillo, Fabrizio (2014) An Unusual case of excessive sweating affecting the right upper limb after bilateral endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: recurrence or compensatory hyperhidrosis? European Surgery, Vol. 46 (4), p. 169-172. ISSN 1682-8631. eISSN 1682-4016. Article.

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DOI: 10.1007/s10353-014-0275-7

Abstract

Introduction: Hyperhidrosis is excessive perspiration beyond physiological needs and can be primary (essential, idiopathic) or secondary to drugs, toxins, substance abuse, and several medical conditions. Primary hyperhidrosis generally involves the palms, axillae, and face. Herein, we report an unusual case of excessive sweating after endoscopic thoracic sympathectomy, which was misinterpreted as recurrence due to improper surgery.
Methods: A 31-year-old male patient underwent bilateral T3-T4 videothoracoscopic sympathicotomy for primary palmar hyperhidrosis.
Results: After the surgery, the patient complained about sweating of the right axillae and palm, and underwent reoperation at the right side, which revealed correct division of the sympathetic chain and absence of visible communicating nerves between the stubs. Subsequently, the patient presented with excessive sweating, greater than that prior to surgery, in the right upper limb. This condition was difficult to contextualise as either recurrence, given the correctness of the surgical procedure and higher amount of sweating compared with the preoperative state, or as compensatory hyperhidrosis, given the involvement of body areas affected by surgery.
Conclusions: Compensatory hyperhidrosis may involve areas affected by endoscopic thoracic sympathectomy and thus may be confused with recurrence due to incomplete surgery, leading to unnecessary surgical re-interventions.

Item Type:Article
ID Code:10001
Status:Published
Refereed:Yes
Uncontrolled Keywords:Hyperhidrosis, sympathicotomy, sympathectomy, TES, sympathetic trunk
Subjects:Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
Publisher:Springer Vienna
ISSN:1682-8631
eISSN:1682-4016
Copyright Holders:© Springer-Verlag Wien 2014
Deposited On:07 Aug 2014 12:20

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