{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:49:24Z","timestamp":1783662564473,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,9,24]],"date-time":"2010-09-24T00:00:00Z","timestamp":1285286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2011,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Palmoplantar hyperhidrosis is a common disease that leads to significant psychosocial strain for the affected person. Although the treatment of palmar symptoms with endoscopic thoracic sympathectomy (ETS) is clinically established, there are few data on the efficacy of an endoscopic lumbar sympathectomy (ELS) for the elimination of plantar symptoms. Especially the occurrence of unwanted side effects associated with sequential ETS and ELS has not been examined sufficiently.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study includes 130 patients, 8\u00a0men and 122 women, with severe palmoplantar hyperhidrosis who were already previously treated with ETS. An average of 28\u00a0months after the ETS, bilateral ELS was performed on all patients due to persistent severe plantar hyperhidrosis. After ELS the perioperative morbidity, elimination rate of the plantar hyperhidrosis, the frequency of unwanted side effects, and satisfaction with the result were evaluated. Follow\u2010up examinations were carried out on 96 patients (74%) with a mean follow\u2010up of 37\u00a0months (3\u201390\u00a0months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 260 lumbar sympathectomies were successfully carried out endoscopically. Mortality was zero, intraoperative complications occurred in three (2.3%) patients and postoperative complications in six (4.6%). Plantar hyperhidrosis was eliminated in 93 patients (97%), 3 (3%) patients developed a one\u2010sided recurrence. Seven patients (7%) developed minor compensatory sweating, and in 17 patients (18%) compensatory sweating that existed before the ELS was slightly increased. Transient postsympathectomy neuralgia was observed in 18 patients (19%), and none of the patients showed a sexual function disorder. Altogether, 77 patients (80%) were very satisfied with the postoperative result, and 16 (17%) were partially satisfied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The sesequential performance of ELS after ETS appears to be a safe, effective therapy option for patients with severe palmoplantar hyperhidrosis. However, more experience with a larger number of patients and longer follow\u2010up investigations are necessary to confirm the safety of four\u2010limb sympathectomy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-010-0801-0","type":"journal-article","created":{"date-parts":[[2010,9,22]],"date-time":"2010-09-22T22:34:23Z","timestamp":1285194863000},"page":"49-53","source":"Crossref","is-referenced-by-count":25,"title":["Endoscopic Lumbar Sympathectomy Following Thoracic Sympathectomy in Patients with Palmoplantar Hyperhidrosis"],"prefix":"10.1002","volume":"35","author":[{"given":"Roman","family":"Rieger","sequence":"first","affiliation":[{"name":"Department of Surgery Landeskrankenhaus Gmunden Miller von Aichholzstrasse 49 4810 Gmunden Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"de Paula Loureiro","sequence":"additional","affiliation":[{"name":"Hospital Santa Cruz de Curitiba, Jaques Perissat Institut, Postgraduate Course in Minimally 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