Sympathectomy in the treatment of primary axillary and palmar hyperhidrosis: what does the evidence say?
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Introdução: Hiperidrose primária se caracteriza pela produção excessiva de suor, ultrapassando o necessário para regular a temperatura corporal, com consequências negativas no cotidiano. Determinados casos são refratários às terapias e medicamentos. A simpatectomia visa a ressecção de cadeias simpáticas para redução do suor.
Objetivo: Avaliar as repercussões da simpatectomia torácica na hiperidrose primária palmar e axilar, analisando os indicativos relacionados à qualidade de vida e satisfação dos pacientes após o procedimento.
Método: Revisão baseada na análise de dados do Pubmed e BVS, considerando a literatura disponível de janeiro/2014 até janeiro/2024, utilizando artigos em português e inglês que entraram nos critérios de inclusão estipulados e apoiados no Prisma 2020.
Resultado: Os estudos revisados contabilizaram total de 4139 pacientes. A taxa de satisfação com a simpatectomia variou de 78,6 a 100%. Dependendo da técnica resultou entre 28,8% e 98,1% de hiperidrose compensatória. Cerca de 87% dos pacientes alegaram significativa melhora na qualidade de vida, com avanços funcionais e sociais, evidenciados por escores aumentados e benefícios em atividades cotidianas.
Conclusão: Simpatectomia mostrou-se eficaz, segura e com impactos positivos na vida dos pacientes. No entanto, há necessidade da padronização dos questionários referentes à qualidade de vida, duração e periodicidade do acompanhamento pós-operatório e aprimoramento das técnicas para reduzir a hiperidrose compensatória.
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