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A systematic review and meta‐analysis to evaluate the efficacy of lumbar sympathectomy for plantar hyperhidrosis
Author(s) -
Lima Sonia O.,
Santos Rafael S.,
Moura Amanda M. M.,
Neto Edinaldo G.,
Andrade Renata L. B.,
Valido Arthur D.,
dos Santos Vivian F.,
Mendonça Ana K. R. H.
Publication year - 2019
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14470
Subject(s) - medicine , sympathectomy , hyperhidrosis , lumbar sympathectomy , lumbar , surgery , anesthesia
On July 25, 2017, we conducted an extensive database tracking to identify all studies published from January 1990 to July 2017. Screening updates were performed until December 2017. Results There were no deaths, and the resolution of symptoms of primary plantar hyperhidrosis (PPH) occurred in 92% of patients after mechanical sympathectomy. A total of 177 patients (44%) were reported to have mild to severe compensatory sweating after a mean 6 months follow‐up. The preservation of L2 did not interfere with the primary outcome, and it is possible to perform lumbar sympathectomy in men with L2 preservation, achieving satisfactory cure results of PPH, minimizing the risk of sexual dysfunction. There were no deaths, and the resolution of symptoms of PPH occurred in 10% of patients after chemical sympathicolysis after a mean 6 months follow‐up. A total of 13 patients (12.5%) were reported to have mild to severe compensatory sweating using the same technique. Conclusion The mechanical lumbar sympathectomy is effective and safe and improves quality of life, evaluated by the high symptom resolution of PPH and low rate of complications. The chemical sympathicolysis in the immediate postoperative period presented satisfactory results; however, it was shown to be significantly less effective than the mechanical approach in a follow‐up of at least 6 months.