Skip to main content
SpringerLink
Log in

Quality of Life After Endoscopic Lumbar Sympathectomy for Primary Plantar Hyperhidrosis

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Primary plantar hyperhidrosis is characterised by excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle. The aim of this prospective study was to assess the effect of endoscopic lumbar sympathectomy (ESL) on the quality of life (QL) of patients with primary plantar hyperhidrosis.

Methods

Bilateral ESL was performed on 52 patients, 31 men and 21 women with primary plantar hyperhidrosis. Perioperative morbidity and clinical results were evaluated in all patients after a mean follow-up of 15 months. Postoperative QL was examined with the SF-36V2 questionnaire and the hyperhidrosis-specific questionnaires devised by Milanez de Campos and Keller.

Results

All procedures were carried out endoscopically with no perioperative morbidity. Plantar hyperhidrosis was eliminated in 50 patients (96 %) and two patients (4 %) suffered a relapse. Unwanted side effects occurred in the form of compensatory sweating in 34 (65 %) and in the form of postsympathectomy neuralgia in 19 patients (37 %). Ninety six percentage of patients were satisfied with the postoperative result and 88 % would have the surgery repeated. The SF-36V2 questionnaire revealed a significant improvement of QL after lumbar sympathectomy in physical health (physical component summary, p < 0.01) as well as mental health (mental component summary, p < 0.05). Improved QL was also demonstrated in the Milanez de Campos questionnaire in the dimensions functionality/social interactions (p < 0.01), intimacy (p < 0.01), emotionality (p < 0.01) and specific circumstances (p < 0.01) as well as in the Keller questionnaire in the area of plantar hyperhidrosis (p < 0.01).

Conclusion

The performance of an ESL in patients with primary plantar hyperhidrosis leads to the effective elimination of excessive sweat secretion of the feet and to an increase in QL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Haider A, Solish N (2005) Focal hyperhidrosis: diagnosis and management. CMAJ 172:69–75

    Article  PubMed Central  PubMed  Google Scholar 

  2. Rieger R, Pedevilla S, Pöchlauer S (2009) Endoscopic lumbar sympathectomy for plantar hyperhidrosis. Br J Surg 96:1422–1428

    Article  CAS  PubMed  Google Scholar 

  3. Walling HW (2009) Primary hyperhidrosis increases the risk of cutaneous infection: a case-controlled study of 387 patients. J Am Acad Dermatol 61:242–246

    Article  PubMed  Google Scholar 

  4. Hornberger J, Grimes K, Naumann M, Glaser DA, Lowe NJ, Naver H, Ahn S, Stolman LP, on behalf of the Multi-Specialty Working Group on the Recognition, Diagnosis, and Treatment of Primary Focal Hyperhidrosis (2004) Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 51:274–286

    Article  PubMed  Google Scholar 

  5. Eisenach JH, Atkinson JLD, Fealey RD (2005) Hyperhidrosis: evolving therapies for a well-established phenomenon. Mayo Clin Proc 80:657–666

    Article  PubMed  Google Scholar 

  6. Loureiro MP, Milanez De Campos JR, Kauffman P, Jatene FB, Weigman S, Fontana A (2008) Endoscopic lumbar sympathectomy for women: effect on compensatory sweat. Clinics 63:189–196

    Article  Google Scholar 

  7. Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, Smith KC, Storwick G, Canadian Hyperhidrosis Advisory Committee (2007) A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg 33:908–923

    CAS  PubMed  Google Scholar 

  8. Rieger R, Pedevilla S (2007) Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings. Surg Endosc 21:129–135

    Article  CAS  PubMed  Google Scholar 

  9. Milanez de Campos JR, Kauffman P, de Campos Werebe E, Filho AF, Kusniek S, Wolosker N, Jatene FB (2003) Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg 76:886–891

    Article  Google Scholar 

  10. Keller SM, Sekons D, Scher H, Homel P, Bookbinder M (2001) A novel scale for assessing quality of life following bilateral endoscopic sympathectomy for palmar and plantar hyperhidrosis. Fourth International Symposium on Sympathetic Surgery, Tampere, Finland, 28–30 June 2001; Abstract 0–22

  11. Nicolas C, Grosdidier G, Granel F, Barbaud A, Schmutz JL (2000) Endoscopic sympathectomy for palmar and plantar hyperhidrosis: results in 107 patients. Ann Dermatol Venereol 127:1057–1063

    CAS  PubMed  Google Scholar 

  12. Ware JE, Gandek B (1998) Overview of the SF-36 health survey and the International Quality of Life Asessment (IQOLA) project. J Clin Epidemiol 220:86–90

    Google Scholar 

  13. Garrat AM, Ruta DA, Abdalla MI, Buckingham JK, Russel IT (1993) The SF-36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ 306:1440–1444

    Article  Google Scholar 

  14. McHorney CA, Ware JE, Raczek AE (1993) The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31:247–263

    Article  CAS  PubMed  Google Scholar 

  15. Guyatt GH, Feeny DH, Patrick DL (1993) Measuring health-related quality of life. Ann Int Med 118:622–629

    Article  CAS  PubMed  Google Scholar 

  16. Panhofer P, Neumayer C, Zacherl J, Jakesz R, Bischof G (2005) A survey and validation guide for health-related quality-of-life status in surgical treatment of hyperhidrosis. Eur Surg 37(3):143–152

    Article  Google Scholar 

  17. Sayeed RA, Nyamekye I, Ghauri AS, Poskitt KR (1998) Quality of life after transthoracic endoscopic sympathectomy for upper limb hyperhidrosis. Eur J Surg Suppl 580:39–42

    PubMed  Google Scholar 

  18. Lau WT, Lee JD, Dang CR, Lee L (2001) Improvement in quality of life after bilateral transthoracic endoscopic sympathectomy for palmar hyperhidrosis. Hawaii Med J 60:126–137

    CAS  PubMed  Google Scholar 

  19. Panhofer P, Zacherl J, Jakesz R, Bischof G, Neumayer C (2006) Improved quality of life after sympathetic block for upper limb hyperhidrosis. Br J Surg 93:582–586

    Article  CAS  PubMed  Google Scholar 

  20. Kumagai K, Kawase H, Kawanishi M (2005) Health-related quality of life after thoracic sympathectomy for palmar hyperhidrosis. Ann Thorac Surg 80:461–466

    Article  PubMed  Google Scholar 

  21. Tetteh HA, Groth SS, Kast T, Whitson BA, Radosevich DM, Klopp AC, D´Cunha J, Maddaus MA, Andrade RS (2009) Primary palmoplantar hyperhidrosis and thoracoscopic sympathectomy: a new objective assessment method. Ann Thorac Surg 87:267–274

    Article  PubMed  Google Scholar 

  22. Wolosker N, Yazbek G, Milanez de Campos JR et al (2010) Quality of life before surgery is a predictive factor for satisfaction among patients undergoing sympathectomy to treat hyperhidrosis. J Vasc Surg 51:1190–1194

    Article  PubMed  Google Scholar 

  23. Kopelman Hashmonai M (2008) The correlation between the method of sympathetic ablation for palmar hyperhidrosis and the occurrence of compensatory hyperhidrosis: a review. World J Surg 32:2343–2356. doi:10.1007/s00268-008-9716-4

    Article  PubMed  Google Scholar 

  24. Buche M, Randour P, Mayne A, Joucken K, Schoevaerdts JC (1988) Neuralgia following lumbar sympathectomy. Ann Vasc Surg 2:279–281

    Article  CAS  PubMed  Google Scholar 

  25. Litwin MS (1962) Postsympathectomy Neuralgia. Arch Surg 84:121–125

    Article  Google Scholar 

  26. Whitelaw GP, Smithwick RH (1951) Some secondary effects of sympathectomy. With particular reference to disturbance of sexual function. New Eng J Med 245:121–130

    Article  CAS  PubMed  Google Scholar 

  27. Rose SS (1953) An investigation into sterility after lumbar ganglionectomy. Br Med J 1:247–250

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Simeone FA (1977) The lumbar sympathetic. Anatomy and surgical implications. Acta Chir Belg 1:17–26

    Google Scholar 

  29. Rieger R, Loureiro MP, Pedevilla S, Oliveira RA (2011) Endoscopic lumbar sympathectomy following thoracic sympathectomy in patients with palmoplantar hyperhidrosis. World J Surg 35:49–53. doi:10.1007/s00268-010-0801-0

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Prof.Dr.Werner Pölz, Institute for Applied Systems Research and Statistics, University of Linz, for performing the statistical analysis.

Conflict of interest

Roman Rieger, Sonja Pedevilla and Johannes Lausecker have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Salzkammergut-Klinikum Gmunden, Miller von Aichholzstrasse 49, 4810, Gmunden, Austria

    Roman Rieger, Sonja Pedevilla & Johannes Lausecker

Authors
  1. Roman Rieger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sonja Pedevilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Johannes Lausecker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roman Rieger.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rieger, R., Pedevilla, S. & Lausecker, J. Quality of Life After Endoscopic Lumbar Sympathectomy for Primary Plantar Hyperhidrosis. World J Surg 39, 905–911 (2015). https://doi.org/10.1007/s00268-014-2885-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2885-4

Keywords

Search

Navigation