Endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: intermediate term results

BACKGROUND

The authors' experience of the efficacy and safety of endoscopic thoracic sympathectomy in the treatment of primary palmer hyperhidrosis was examined.

METHODS

A retrospective study of 71 patients (126 sympathectomies) was undertaken. Data were retrieved by hospital records and telephone interview.

RESULTS

Follow-up was possible for 92 sympathectomies in 53 patients. Overall, satisfactory results were achieved in 93% of patients and complications were uncommon. Compensatory hyperhidrosis was the most common complication, which occurred in 64% of patients; the trunk and feet were the most common sites. Horner's syndrome occurred in five patients, although in two it was a permanent complication. No patient expressed dissatisfaction with the procedure as a consequence of this complication. Pneumothorax occurred in 17.5% of cases, although the vast majority were incidental findings on a postoperative chest X-ray, and none required drainage. With the newer techniques of access, patient dissatisfaction with the cosmetic appearance has fallen from 27.3 to 6.4%. Overall 90% of patients said they would have the operation again, which represents a high level of patient satisfaction.

CONCLUSIONS

Endoscopic thoracic sympathectomy is a safe and effective technique for primary palmer hyperhidrosis. Evolution of the technique has resulted in improvement in patient satisfaction.