Prognosis analysis of R2 intervention surgery in patients with primary craniofacial hyperhidrosis: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Hong ^1,2 , FENG Zhi ^1,3 , TU Yuanrong ^1,3 , LIN Min ^1,3 , WANG Zijie ^1,2 ,  DU Quan ^1,3 ,  CHEN Jianfeng ^1,3

1. Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, P. R. China;
2. First Clinical School of Fujian Medical University, Fuzhou, 350122, P. R. China;
3. Department of Thoracic Surgery, Binhai Campus National Regional Medical Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350212, P. R. China;

Corresponding author：

DU Quan, Email: 49997929@qq.com; CHEN Jianfeng, Email: chenjianfeng@fjmu.edu.cn

Keywords：

Primary craniofacial hyperhidrosis; R2 intervention surgery; compensatory hyperhidrosis; recurrence; satisfaction; predictive model

DOI：

10.7507/1007-4848.202409007

Video：

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Objective To investigate the prognosis and satisfaction of the R2 intervention procedure and develop related predictive models. Methods The clinical data of 64 patients with primary hyperhidrosis who underwent R2 intervention surgery at the First Affiliated Hospital of Fujian Medical University from November 2018 to October 2022 were retrospectively analyzed. By statistically analyzing the risk factors for compensatory hyperhidrosis (CH) and satisfaction, and conducting feature screening, a relevant prediction model was established. Results Finally, 51 patients were collected, including 43 (84.3%) males and 8 (15.7%) females, with an average age of (30.27±7.22) years. Overall postoperative satisfaction was high, with only 5.9% of patients expressing regret about the surgery. However, 92.2% of patients experienced CH, the severity of which gradually decreased within three months postoperatively. Preoperative heart rate and R2 sympathetic nerve clipping were identified as independent risk factors for severe CH. Satisfaction analysis revealed that BMI and sweating in the thoracoabdominal region were significantly associated with satisfaction. Conclusion The R2 intervention surgery effectively alleviates the symptoms of primary craniofacial hyperhidrosis, and patient satisfaction is high.

1.	Jeong SC, Kim JJ, Kim YH, et al. Heart rate variability as a potential diagnostic tool to predict compensatory hyperhidrosis after sympathectomy in patients with primary focal hyperhidrosis. J Thorac Dis, 2020, 12(11): 6789-6796.
2.	Moon DH, Kang DY, Lee HS, et al. To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis. J Thorac Dis, 2020, 12(5): 2529-2535.
3.	Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options. J Am Acad Dermatol, 2019, 81(3): 669-680.
4.	Kristensen JK, Vestergaard DG, Swartling C, et al. Association of primary hyperhidrosis with depression and anxiety: A systematic review. Acta Derm Venereol, 2020, 100(1): adv00044.
5.	Han Z, Rui M, Zhang Z, et al. Development and validation of a nomogram to predict recurrence of primary hyperhidrosis after CT-guided percutaneous radiofrequency sympathectomy. J Vasc Interv Radiol, 2023, 34(11): 1892-1900.
6.	Nicholas R, Quddus A, Baker DM. Treatment of primary craniofacial hyperhidrosis: A systematic review. Am J Clin Dermatol, 2015, 16(5): 361-370.
7.	Woo W, Kim BJ, Kang DY, et al. Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy. Surg Endosc, 2022, 36(11): 8340-8348.
8.	Toolabi K, Parsaei R, Farid R, et al. Endoscopic thoracic sympathotomy for primary hyperhidrosis: Predictors of outcome over a 10-year period. Surg Endosc, 2022, 36(5): 3585-3591.
9.	Wolosker N, Faustino CB, de Campos JRM, et al. Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients. J Pediatr Surg, 2020, 55(3): 418-424.
10.	Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
11.	Hajjar WM, Al-Nassar SA, Al-Sharif HM, et al. The quality of life and satisfaction rate of patients with upper limb hyperhidrosis before and after bilateral endoscopic thoracic sympathectomy. Saudi J Anaesth, 2019, 13(1): 16-22.
12.	Han JW, Kim JJ, Kim YH, et al. New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis. J Thorac Dis, 2020, 12(3): 765-772.
13.	Akil A, Semik M, Fischer S. Efficacy of miniuniportal video-assisted thoracoscopic selective sympathectomy (ramicotomy) for the treatment of severe palmar and axillar hyperhidrosis. Thorac Cardiovasc Surg, 2019, 67(5): 415-419.
14.	Liu Y, Weng W, Tu Y, et al. Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version). Chin Med J (Engl), 2022, 135(11): 1264-1271.
15.	Yazbek G, Ishy A, Alexandrino da Silva MF, et al. Evaluation of compensatory hyperhidrosis after sympathectomy: The use of an objective method. Ann Vasc Surg, 2021, 77: 25-30.
16.	Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
17.	Lee J, Jeong JY, Suh JH, et al. Thoracoscopic sympathetic block to predict compensatory hyperhidrosis in primary hyperhidrosis. J Thorac Dis, 2021, 13(6): 3509-3517.

1. Jeong SC, Kim JJ, Kim YH, et al. Heart rate variability as a potential diagnostic tool to predict compensatory hyperhidrosis after sympathectomy in patients with primary focal hyperhidrosis. J Thorac Dis, 2020, 12(11): 6789-6796.
2. Moon DH, Kang DY, Lee HS, et al. To avoid compensatory hyperhidrosis after sympathetic surgery for craniofacial hyperhidrosis. J Thorac Dis, 2020, 12(5): 2529-2535.
3. Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Therapeutic options. J Am Acad Dermatol, 2019, 81(3): 669-680.
4. Kristensen JK, Vestergaard DG, Swartling C, et al. Association of primary hyperhidrosis with depression and anxiety: A systematic review. Acta Derm Venereol, 2020, 100(1): adv00044.
5. Han Z, Rui M, Zhang Z, et al. Development and validation of a nomogram to predict recurrence of primary hyperhidrosis after CT-guided percutaneous radiofrequency sympathectomy. J Vasc Interv Radiol, 2023, 34(11): 1892-1900.
6. Nicholas R, Quddus A, Baker DM. Treatment of primary craniofacial hyperhidrosis: A systematic review. Am J Clin Dermatol, 2015, 16(5): 361-370.
7. Woo W, Kim BJ, Kang DY, et al. Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy. Surg Endosc, 2022, 36(11): 8340-8348.
8. Toolabi K, Parsaei R, Farid R, et al. Endoscopic thoracic sympathotomy for primary hyperhidrosis: Predictors of outcome over a 10-year period. Surg Endosc, 2022, 36(5): 3585-3591.
9. Wolosker N, Faustino CB, de Campos JRM, et al. Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients. J Pediatr Surg, 2020, 55(3): 418-424.
10. Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
11. Hajjar WM, Al-Nassar SA, Al-Sharif HM, et al. The quality of life and satisfaction rate of patients with upper limb hyperhidrosis before and after bilateral endoscopic thoracic sympathectomy. Saudi J Anaesth, 2019, 13(1): 16-22.
12. Han JW, Kim JJ, Kim YH, et al. New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis. J Thorac Dis, 2020, 12(3): 765-772.
13. Akil A, Semik M, Fischer S. Efficacy of miniuniportal video-assisted thoracoscopic selective sympathectomy (ramicotomy) for the treatment of severe palmar and axillar hyperhidrosis. Thorac Cardiovasc Surg, 2019, 67(5): 415-419.
14. Liu Y, Weng W, Tu Y, et al. Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version). Chin Med J (Engl), 2022, 135(11): 1264-1271.
15. Yazbek G, Ishy A, Alexandrino da Silva MF, et al. Evaluation of compensatory hyperhidrosis after sympathectomy: The use of an objective method. Ann Vasc Surg, 2021, 77: 25-30.
16. Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
17. Lee J, Jeong JY, Suh JH, et al. Thoracoscopic sympathetic block to predict compensatory hyperhidrosis in primary hyperhidrosis. J Thorac Dis, 2021, 13(6): 3509-3517.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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