-este articulo lo publican novatos q se acaban de liceniar en cirujia toracica en brasil y estan ansiosos por empezar a sacar dinero
-q la simpatectomia lumbar es una importante arma para evitar la hh-plantar
-q el 40% de los operados de simpatectomia toracica no nota reducion en su hh-plantar
-q en ese 40% de operados no satisfechos recomiendan volverse a operar pero esta vez de simpatectomia lumbar
-reclutaron para sus practicas a 30 mujeres que ya se habian operado de simpatectomia toracica para VOLVERLAS A OPERAR de lumbar ya que su hh-plantar no fue aliviada en la primera operacion
-el 20% de las operadas presento dolor prolongado durante mas de 10 dias siguientes a la operacion
-el 53% de las operadas presento un sc mas grande (en espalda y abdomen) q el q tenia antes de operarse
-concluyen diciendo q la simpatec lumbar disminuye la hh-plantar PERO QUE LA MITAD DE LOS OPERADOS QUEDO CON UN SC MAYOR QUE EL QUE TENIA ANTES YA QUE APARECIO EN OTRAS PARTES DEL CUERPO

http://www.ncbi.nlm.nih.gov/pubmed/18438572?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

1: Clinics. 2008 Apr;63(2):189-96. 
Endoscopic lumbar sympathectomy for women: effect on compensatory sweat.Loureiro Mde P, Campos JR, Kauffman P, Jatene FB, Weigmann S, Fontana A.
Programa de Ps-Graduao em Cincias - Cirurgia Torcica e Cardiovascular, Faculdade de Medicina, Universidade de So Paulo, So Paulo, SP, Brazil.

INTRODUCTION: Plantar hyperhidrosis is present in 50% of patients with hyperhidrosis. Thoracic sympathectomy is an important tool for the treatment of this condition, which is successful in about 60% of patients. For the remaining patients, lumbar sympathectomy is the procedure of choice. As new minimally invasive techniques have been developed, a significant demand for this type of access has led to its adaptation to the lumbar sympathectomy. The objective of this study was to evaluate the effectiveness of endoscopic retroperitoneal lumbar sympathectomy in controlling plantar hyperhidrosis and its effects on compensatory sweat. MATERIALS AND METHODS: Thirty female patients with persistent plantar hyperhidrosis after thoracic sympathectomy were enrolled. They were randomly assigned to laparoscopic retroperitoneal lumbar sympathectomy (Group A) or no surgical intervention (Group B - control) groups. Quality-of-life modifications were assessed by specific questionnaires before and after surgery. In the same manner, direct sweat measurements were also performed pre- and post-intervention by evaluating trans-epidermal water loss. Despite the lack of intervention, the control group was evaluated at similar timepoints. RESULTS: In Group A, no major complications occurred in the peri-operative period. During the immediate post-operative period, three patients (20%) experienced prolonged pain (more than ten days). Eight patients suffered from worsened compensatory sweating (53.3%). In Group A, after lumbar sympathectomy, the quality of life significantly improved (p<0.05, intra-group comparison) beyond that of the control group (p<0.05, inter-group comparison). Also, lumbar sympathectomy resulted in significantly lower values of foot sweat (pre- vs. post-operative periods, p<0.05; Group A vs. Group B, p<0.05). These patients also developed higher values of sweat measurements on specific points of their dorsal and abdominal regions after the procedure (p<0.05). CONCLUSIONS: The endoscopic retroperitoneal lumbar sympathectomy diminishes plantar sweat and improves the quality of life of women with plantar hyperhidrosis. However, about half of the patients develop increased compensatory hyperhidrosis in other areas of the body.

PMID: 18438572 [PubMed - in process]
