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"Incidence of Compensatory Hyperhidrosis After T3 Vs T3-4 Sympathectomy"

NCT07196319 — Not yet recruiting, 46 participants, Assiut University

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"From One Problem to Another, Comparing the Incidence of Compensatory Hyperhidrosis After T3 Vs. T3-4 Sympathectomy"

RegistryNCT07196319
StatusNot yet recruiting
Study typeObservational
Enrollment46 (Estimated)
SponsorAssiut University (Other)
ConditionsCompensatory Hyperhidrosis, Compensatory Sweating
Datesstart 2025-11-15 (estimated), primary completion 2027-10-20 (estimated), completion 2028-10-25 (estimated), first posted 2025-09-29, last updated 2025-10-03

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-Summary

The goal of this study is to compare the proportion of compensatory hyperhidrosis patients after sympathectomy at T3 level and sympathectomy at T3-4 level. The main question it aims to answer is:

can sympathectomyv at one level decrease the incidence of compensatory hyperhidrosis after primary hyperhidrosis.

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+Detailed description

Primary hyperhidrosis is a chronic condition characterized by excessive sweating beyond physiological needs, commonly affecting the palms, axillae, face, or soles. This disorder is largely attributed to neurogenic hyperexcitability within the sympathetic nervous system's pathways innervating the eccrine sweat glands.When conservative treatments such as topical agents or oral medications fail, endoscopic thoracic sympathectomy (ETS) is considered an effective surgical option. However, a major postoperative complication is compensatory hyperhidrosis (CH)-the development of excessive sweating in previously unaffected areas such as the trunk, back, or thighs. CH can significantly impact patient satisfaction and quality of life, often becoming more distressing than the original condition.

The extent and level of sympathectomy have been proposed as key factors influencing the incidence and severity of CH. While higher levels or multilevel resections (e.g., T2-4) are associated with increased rates of CH, more limited approaches such as T3-only resection are thought to reduce this risk. However, definitive evidence comparing T3 versus T3-4 sympathectomy remains limited and inconsistent across studies.

This study aims to compare the incidence and severity of compensatory hyperhidrosis following T3 versus T3-4 sympathectomy for primary hyperhidrosis. Understanding these differences may help refine surgical approaches to minimize CH and improve patient outcomes.

+Arms and interventions

ArmTypeInterventionsDescription
T3 sympathectomypatients who underwent T3 sympathectomy for primary hyperhidrosis
T3-4 sympathectomypatients who underwent through T3-4 sympathectomy for primary hyperhidrosis

+Outcome measures

Primary outcomes

  • To compare the incidence of compensatory hyperhidrosis following T3 versus T3-4 sympathectomy. [1 year post-sympathectomy]

Secondary outcomes

  • severity of Compensatory hyperhidrosis by hyperhidrosis disease severity scale [1 year post sympathectomy]: 1. The sweating is never noticeable and doesn't interfere with daily activities. 2. The sweating is tolerable but sometimes interferes with daily activities. 3. The sweating is barely tolerable and frequently interferes with daily activities. 4. The sweating is intolerable and always interferes with daily activities.
  • recurrence rates of primary hyperhidrosis [1 year post sympathectomy]
  • site of compensatory hyperhidrosis [1year post sympathectomy]

+Eligibility

Sex: All, ages: 6 Years to any

Inclusion Criteria:

* Patients diagnosed with primary hyperhidrosis
* Patients with palmar and\\or axillary hyperhidrosis.
* Age ≥ 6 years

Exclusion Criteria:

* History of Prior thoracic surgery.
* History of prior disorder that cause hyperhidrosis ( obesity,autonomic neuropathy,menopause,gout,etc…)
* History of prior systemic diseases cause hyperhidrosis (hyperthyroidism,DM,pheochromocytoma,Parkinson's disease,etc…)
* Patients with psychological problems.

+Publications

  • Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009 Nov;41(4):1149-60. doi: 10.3758/BRM.41.4.1149. PMID 19897823
  • Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004 Aug;51(2):241-8. doi: 10.1016/j.jaad.2003.12.040. PMID 15280843
  • 4. Lin TS, et al. Clinical experience of thoracoscopic sympathetic block for primary hyperhidrosis: analysis of 3450 cases. J Thorac Cardiovasc Surg. 2001;121(3):566-74.
  • 3. Hussein AF, et al. Unilevel (T3) versus Bilevel (T3 - T4) Sympathictomy in the Management of Palmar Hyperhidrosis: A Prospective Comparative Study. Clinics (Sao Paulo). 2024.
  • 2. Liu X, Wang J, Liu Z, Sun X, Zheng J. Comparison of only T3 and T3-T4 sympathectomy for axillary hyperhidrosis: a retrospective study. J Thorac Dis. 2018;10(4):2095-101.
  • Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146. PMID 17695343
  • Licht PB, Pilegaard HK. Severity of compensatory sweating after thoracoscopic sympathectomy. Ann Thorac Surg. 2004 Aug;78(2):427-31. doi: 10.1016/j.athoracsur.2004.02.087. PMID 15276490

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