Clinical Benefits of Thoracoscopic Sympathectomy on Palmar Hyperhidrosis

Salih Duman

Keywords: Palmar Hyperhidrosis, Sympathectomy, Thoracoscopic, ETS

Aim:

Hyperhidrosis is a medical condition that can cause significant social problems for patients. There are several non-invasive and invasive treatment options available. Thoracic sympathectomy is the preferred treatment option for hyperhidrosis. Our aim is to evaluate a single center's experience and the outcomes of thoracic sympathectomy in managing hyperhidrosis.

Method:

This study includes a retrospective analysis of 79 patients, with a median age of 22 years, who underwent thoracic sympathectomy between 2006 and 2023 at the Thoracic Surgery Department of Istanbul University Istanbul Medical School. Of the patients, 37 were male, and 42 were female. All patients consulted with an internal medicine specialist and a dermatology specialist before the operation, and several blood biochemical tests were conducted. Of the total patients, 78 underwent bilateral thoracic sympathectomies performed with clipping or cauterization of the sympathetic nerves at T2-4, T3-4, or T3 levels. Only one patient had a dominant-sided operation due to severe bradycardia.

Results:

Complete symptomatic relief of palmar hyperhidrosis was achieved in all patients. The median hospital stay was one day. Following surgery, three patients required intervention for pneumothorax and were discharged two days later after the placement of a chest tube. Nine patients experienced recurrent hyperhidrosis after the operation, and 25 patients experienced generalized mild compensatory sweating. There was no statistical relevance between age and compensatory sweating (p=0.3).

Conclusions:

This study provides evidence that thoracic sympathectomy is an effective and satisfactory treatment option for palmar hyperhidrosis, with an acceptable complication rate. The study's findings indicate that this procedure can provide complete relief of symptoms and improve patients' quality of life.

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