PURPOSE: Thoracoscopic sympathectomy (TS) is the treatment of choice for primary hyperhidrosis, a condition that leads to social and psychological effects. However, it is of paramount importance the correct indication of the surgical procedure, once the ablation of the sympathetic chain is irreversible and may lead to compensatory sweating. We report our experience with video-assisted TS in the treatment of hyperhidrosis.
METHODS: We performed video assisted TS to treat primary hyperhidrosis in 467 patients: 5 facial (t2), 20 axillary (t3-4), 222 palmar (t3) and 220 mixed (t3-4). Indication for surgery was based on evaluation of the body mass index (BMI) and the degree of social and functional limitations (score 1-4). A post operative 30 days evaluation of the facial, hands, axillary and feet results (score 1-4) and compensatory sweat was used to describe the outcome of the procedure. We also describe the presence of pleural adhesions and the need of re-intervention. Statistics: ANOVA.
RESULTS: Palmar and mixed (axillary, hands and feet) types of hyperhidrosis were predominant. All cases selected for surgery had substantial social and/or functional limitations and BMI < 25 (Table).
CONCLUSION: Results of video assisted thoracoscopy for the different forms of hyperhidrosis were considered excellent, and compensatory sweat a minor complication. Despite the presence in a few cases of pleural adhesions, low morbidity and low rates of re-intervention were observed.
CLINICAL IMPLICATIONS: Thoracic sympathectomy is an effective method for the treatment of selected cases of hyperhidrosis, with a high rate of postoperative satisfaction.
DISCLOSURE: Evaldo Marchi, No Financial Disclosure Information; No Product/Research Disclosure Information