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Estrella-Gaibor C, Rivero Y, Jaramillo-Montaño F, Veitia L, Cordova Guilarte J, Garcia A. Enhancing Quality of Life: Pre- and Postoperative Assessment in Idiopathic Hyperhidrosis Patients. Cureus 2023; 15:e49588. [PMID: 38156137 PMCID: PMC10754539 DOI: 10.7759/cureus.49588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVE This study aimed to characterize patients, describe surgical complications, and evaluate the pre- and postoperative quality of life (QOL) of individuals who underwent surgery for primary hyperhidrosis (PHH). METHODS A prospective, non-randomized, uncontrolled study was conducted, documenting cases of patients undergoing surgery for PHH at a reference center in La Habana, Cuba, from January 2016 to December 2022. RESULTS A total of 49 cases were described, with a median age of 16 years; 59.1% were female. The most common presentation was palmar-plantar-axillary, observed in 53% of cases. The palmar presentation was more frequent in female patients (p<0.05). Within 24 hours post-procedure, 85.7% of patients showed dryness in the palmar and axillary areas, with surgical complications occurring in 14.3% of cases (intercostal neuritis, pneumothorax, and hemothorax). CH of some form was recorded in 89.8% of cases. At least 30 days after the surgery, 95.9% of the patients reported a significant improvement in their QOL. CONCLUSION Thoracic sympathectomy is an efficient and safe method for treating hyperhidrosis in adolescents, leading to an enhanced QOL. However, this study reported a higher incidence of complications, particularly CH, compared to previous national and international studies.
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Affiliation(s)
- Cesar Estrella-Gaibor
- General Surgery, Ministerio de Salud Pública, Hospital Esmeraldas sur Delfina Torres de Concha, Quito, ECU
| | | | - Flor Jaramillo-Montaño
- Pediatric Surgery, Hospital Instituto Ecuatoriano de Seguridad Social (IESS) Esmeraldas, Quito, ECU
| | - Livan Veitia
- Surgery, Hospital Pediátrico Universitario de Centro Habana, La Habana, CUB
| | | | - Andrea Garcia
- Internal Medicine, Universidad de Oriente, Barcelona, VEN
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Hong Z, Wu X, Sheng Y, Cui B, Bai X, Lu Y, Cheng T, Jin D, Gou Y. Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis. BMC Surg 2023; 23:82. [PMID: 37041509 PMCID: PMC10091614 DOI: 10.1186/s12893-023-01976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND To compare the near and long-term outcomes of endoscopic thoracic sympathectomy (ETS) for palmar, axillary and plantar hyperhidrosis. METHODS We retrospectively analyzed the clinical data of 218 patients with hyperhidrosis who were admitted to the Department of Thoracic Surgery of Gansu Provincial People's Hospital for surgical treatment from April 2014 to August 2021. The patients were divided into three groups according to the method of ETS and the perioperative clinical data and postoperative follow-up data were collected to compare the near and long term outcomes of the three groups. RESULTS There were 197 eligible patients at follow-up, 60 patients in the R4 cut-off group, 95 patients in the R3 + R4 cut-off group and 42 patients in the R4 + R5 cut-off group. There were no statistically significant differences in baseline indicators such as sex, age and positive family history among the three groups (P > 0.05). There was no statistically significant difference between the three groups in terms of operative time (P = 0.148), intraoperative bleeding (P = 0.308) and postoperative hospital stay (P = 0.407). Postoperatively, all three groups showed significant relief of palmar hyperhidrosis symptoms, with the R3 + R4 group having an advantage in terms of relief of axillary hyperhidrosis symptoms, patient satisfaction and quality of life index at 6 months postoperatively and the R4 + R5 group having an advantage in terms of relief of plantar hyperhidrosis symptoms. The difference in compensatory hyperhidrosis at 12 months postoperatively was not statistically significant among the three groups (P = 0.867), but the incidence was higher in the R3 + R4 and R4 + R5 groups than that in the R4 group. CONCLUSION Patients with simple palmar hyperhidrosis can first consider R4 cut-off treatment; R3 + R4 cut-off is more effective in treating palmar hyperhidrosis combined with axillary hyperhidrosis; R4 + R5 cut-off is more effective in treating palmar hyperhidrosis combined with plantar hyperhidrosis. However, patients need to be informed that R3 + R4 and R4 + R5 dissection may increase the risk of severe compensatory hyperhidrosis after surgery.
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Affiliation(s)
- Ziqiang Hong
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Xusheng Wu
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yannan Sheng
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
| | - Baiqiang Cui
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Xiangdou Bai
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yingjie Lu
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
| | - Tao Cheng
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Dacheng Jin
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yunjiu Gou
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China.
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Liu Y, Liu Y, Fan R, Kehriman N, Zhang X, Zhao B, Huang L. Pharmacovigilance-based drug repurposing: searching for putative drugs with hypohidrosis or anhidrosis adverse events for use against hyperhidrosis. Eur J Med Res 2023; 28:95. [PMID: 36829251 PMCID: PMC9951540 DOI: 10.1186/s40001-023-01048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Drug repurposing refers to the application of existing drugs to new therapeutic indications. As phenotypic indicators of human drug response, drug side effects may provide direct signals and unique opportunities for drug repurposing. OBJECTIVES We aimed to identify drugs frequently associated with hypohidrosis or anhidrosis adverse reactions (that is, the opposite condition of hyperhidrosis) from the pharmacovigilance database, which could be potential candidates as anti-hyperhidrosis treatment agents. METHODS In this observational, retrospective, pharmacovigilance study, adverse event reports of hypohidrosis or anhidrosis in the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) were assessed between January 2004 and December 2021 using reporting odds ratio (ROR) estimates and categorized by the World Health Organization Anatomical Therapeutic Chemical (ATC) classification code. The onset time of drug-associated hypohidrosis or anhidrosis was also examined. RESULTS There were 540 reports of 192 drugs with suspected drug-associated hypohidrosis or anhidrosis in the FAERS database, of which 39 drugs were found to have statistically significant signals. Nervous system drugs were most frequently reported (187 cases, 55.82%), followed by alimentary tract and metabolism drugs (35 cases, 10.45%), genitourinary system and sex hormones (28 cases, 8.36%), and dermatologicals (22 cases, 6.57%). The top 3 drug subclasses were antiepileptics, drugs for urinary frequency and incontinence, and antidepressants. Taking disproportionality signals, pharmacological characteristics of drugs and appropriate onset time into consideration, the main putative drugs for hyperhidrosis were glycopyrronium, solifenacin, oxybutynin, and botulinum toxin type A. Other drugs, such as topiramate, zonisamide, agalsidase beta, finasteride, metformin, lamotrigine, citalopram, ciprofloxacin, bupropion, duloxetine, aripiprazole, prednisolone, and risperidone need more investigation. CONCLUSIONS Several candidate agents among hypohidrosis or anhidrosis-related drugs were identified that may be redirected for diminishing sweat production. There are affirmative data for some candidate drugs, and the remaining proposed candidate drugs without already known sweat reduction mechanisms of action should be further explored.
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Affiliation(s)
- Yi Liu
- grid.411634.50000 0004 0632 4559Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Yanguo Liu
- Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China.
| | - Rongrong Fan
- grid.411634.50000 0004 0632 4559Department of Thoracic Surgery, Peking University People’s Hospital, Beijing, China
| | - Nurmuhammat Kehriman
- grid.11135.370000 0001 2256 9319Department of Pharmaceutical Analysis, School of Pharmacy, Peking University, Beijing, China
| | - Xiaohong Zhang
- grid.411634.50000 0004 0632 4559Department of Pharmacy, Peking University People’s Hospital, Beijing, China
| | - Bin Zhao
- Department of Pharmacy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Lin Huang
- Department of Pharmacy, Peking University People's Hospital, Beijing, China.
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Wang L, Wu X, Tang Y, Fan Z. Postoperative diaphragmatic hernia following endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: A case report. Front Surg 2023; 9:1059604. [PMID: 36684120 PMCID: PMC9852327 DOI: 10.3389/fsurg.2022.1059604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/10/2022] [Indexed: 01/08/2023] Open
Abstract
Postoperative diaphragmatic hernia (DH) following endoscopic thoracic sympathectomy for primary palmar hyperhidrosis is extremely rare. We present a 21-year-old female patient who developed a left DH with herniation of the stomach and gastric perforation on the first postoperative day after undergoing bilateral video-assisted thoracoscopic sympathectomy R4 ablation. She complained of severe dyspnea and chest pain, and an emergency chest x-ray and computed tomography revealed left pleural effusion, collapsed lung, and left DH, which allowed the stomach to herniate into the chest. Emergency thoracoscopic surgery was performed. We repaired the diaphragmatic defect intraoperatively and replaced the stomach with the peritoneal cavity from the thoracic field. The patient was discharged without complications. She did not present with recurrent symptoms at the 3-month follow-up. Postoperative DH should be considered when patients complain of gastrointestinal or respiratory symptoms after sympathectomy, although it is very rare.
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Affiliation(s)
- Ling Wang
- Department of Emergency Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xike Wu
- Department of Cardiothoracic Surgery, The Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China
| | - Yuepu Tang
- Department of Cardiothoracic Surgery, The Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China
| | - Zheyuan Fan
- Department of Cardiothoracic Surgery, The Affiliated Jinyang Hospital of Guizhou Medical University, Guiyang, China,Correspondence: Zheyuan Fan
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