Compensatory sweating after restricting or lowering the level of
                    sympathectomy: a systematic review and meta-analysis

Cai, Song-Wang; Shen, Ning; Li, Dong-Xia; Wei, Bo; An, Jun; Zhang, Jun-Hang

doi:10.6061/clinics/2015(03)11

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Sumário

REVIEW • Clinics 70 (3) • Mar 2015 • https://doi.org/10.6061/clinics/2015(03)11 copy

Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To compare compensatory sweating after lowering or restricting the level of sympathectomy.

METHOD:

A systematic review and meta-analysis were conducted of all randomized controlled trials published in English that compared compensatory sweating after lowering or restricting the level of sympathectomy. The Cochrane collaboration tool was used to assess the risk of bias, and the Mantel-Haenszel odds ratio method was used for the meta-analysis.

RESULTS:

A total of 11 randomized controlled trials were included, including a total of 1079 patients. Five of the randomized controlled trials studied restricting the level of sympathectomy, and the remaining six studied lowering the level of sympathectomy.

CONCLUSIONS:

The compiled randomized controlled trial results published so far in the literature do not support the claims that lowering or restricting the level of sympathetic ablation results in less compensatory sweating.

Sympathectomy; Compensatory sweating; Meta-analysis

Authors	Year	Country	Sympathectomy		Follow-up	n		EG		CG
			EG	CG	(month)	EG	CG	CS	Severe CS	CS	Severe CS
Baumgartner	2011	USA	T3	T2	More than 12	60	61	37	1	43	1
Inan	2008	Turkey	T2-4,T2-3	T2-4	35.3±15.6	60	20	13	absence	3	absence
Ishy	2011	Brazil	T4-5	T3-4	12	20	20	15	1	20	1
Katara	2007	Singapore	T2	T2-3	2-65	25	25	20	0	20	0
Li	2008	China	T3	T2-4	1-12	117	115	25	4	33	11
Licht	2012	Denmark	T2	T2-3	More than 12	42	51	40	0	46	0
Liu	2009	China	T4	T3	17.8±7.9	73	68	39	0	48	0
Mahdy	2008	Egypt	T3-4,T4-5	T2-3	13±8	40	20	11	5	12	7
Munia	2008	Brazil	T4-5	T3-5	12	33	31	14	0	29	0
Yang	2007	China	T4	T3	13.8±6.2	85	78	38	0	55	0
Yazbek	2009	Brazil	T3-4	T2-3	20	30	30	29	4	28	13

Author	Cochrane Risk of Bias Criteria							Jadad score
	Random sequence generation	Allocation concealment	Blinding of participants and personnel	Blinding of outcome assessment	Incomplete outcome data	Selective reporting	Other sources of bias
Baumgartner F.J.	Low	Unclear	High	High	Low	Low	Low	2
Inan K.	Unclear	Unclear	High	High	Low	Low	Low	2
Ishy A	Low	Unclear	High	High	Low	Low	Low	2
Katara A.N.	Low	Low	High	High	Low	Low	Low	3
Li X	Low	Low	High	High	Low	Low	Low	3
Licht PB	Low	Low	Low	Low	High	Low	Low	4
Liu YG	Low	Unclear	High	High	Low	Low	Low	2
Mahdy T	Low	Low	High	High	Low	Low	Low	3
Munia MA	Unclear	Unclear	High	High	Low	Low	Low	2
Yang J	Low	Unclear	High	High	Low	Low	Low	2
Yazbek G	Low	Unclear	High	High	Low	Low	Low	2

Faculdade de Medicina / USP Rua Dr Ovídio Pires de Campos, 225 - 6 and., 05403-010 São Paulo SP - Brazil, Tel.: (55 11) 2661-6235 - São Paulo - SP - Brazil
E-mail: clinics@hc.fm.usp.br

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[1] Cai SW^# and Shen N^# contributed equally to this work and should be considered co-first authors. Cai SW and Zhang JH conceived and designed the experiments. Shen N, Li DX, and Wei B performed the experiments. Cai SW and Li D analyzed the data. Shen N and Jun A contributed reagents/materials/analysis tools. Cai SW and Zhang JH wrote the paper. All of the authors read and approved the final version of the manuscript.

^# These authors contributed equally to this work.