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Comparative Study
. 2020 Jun 10;15(1):133.
doi: 10.1186/s13019-020-01176-1.

Video-assisted thoracoscopic sympathectomy versus modified Wittmoser method in surgical management of primary hyperhidrosis

Duilio Divisi  1 , Gino Zaccagna  2 , Giovanna Imbriglio  2 , William Di Francescantonio  2 , Andrea De Vico  2 , Mirko Barone  2 , Roberto Crisci  2
Affiliations
Comparative Study

Video-assisted thoracoscopic sympathectomy versus modified Wittmoser method in surgical management of primary hyperhidrosis

Duilio Divisi et al. J Cardiothorac Surg. .

Abstract

Purposes: We compared two different surgical methods evaluating the effectiveness of procedures and the quality of life (QoL) of patients.

Methods: From January 2010 to November 2017 we carried out 476 biportal video-assisted thoracoscopic surgery (VATS) approaches of sympathetic chain in 238 patients. One hundred and twenty-nine (54%) patients underwent conventional sympathectomy (CS) while 109 (46%) patients underwent sympathicotomy associated with the division of the rami communicantes (MWT). Quality of Life (QoL) was classified as follows: from 20 to 35 excellent; from 36 to 51 very good; from 52 to 68 good; from 69 to 84 poor; and > 84 very poor.

Results: We noticed statistical significant reduction of complications comparing CS with MWT approaches (chest pain from 36.4 to 4.5%; paresthesias from 8.5 to 3.6%; bradycardia from 28.6 to 10%, respectively). The preoperative and postoperative QoL index evaluation revealed a statistically significant improvement after surgery (CS: 86 ± 2 versus 35 ± 1, p = 0.00001; MWT: 85 ± 1 versus 33 ± 2, p = 0.00001), with general satisfaction of the two techniques.

Conclusion: Modified Wittmoser method seems to be a valid alternative to conventional sympathectomy, minimizing the percentage rate of complications and showing significant effectiveness in the quality of life improvement.

Keywords: Hyperhidrosis; Sympathectomy; Sympathicotomy; Video-assisted thoracic surgery.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Forrest plot - Conventional Sympathectomy (CS) vs Modified Witmoser’s Procedure (MWT); overall morbidity rates
Fig. 2
Fig. 2
Forrest plot - Conventional Sympathectomy (CS) vs Modified Witmoser’s Procedure (MWT); long-term outcomes
See this image and copyright information in PMC

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