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Thoracoscopic sympathetic surgery for hyperhidrosis.

D Y Lee1, Y J Hong, H K Shin

  • 1Department of Thoracic Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. dylee@yumc.yonsei.ac.kr

Yonsei Medical Journal
|February 8, 2000
PubMed
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Thoracoscopic sympathetic surgery effectively treats hyperhidrosis. Minimally invasive techniques like clipping and sympathicotomy reduce complications and improve patient satisfaction for palmar, craniofacial, and axillary sweating.

Area of Science:

  • Surgical treatment of hyperhidrosis
  • Minimally invasive thoracic surgery
  • Sympathetic nervous system interventions

Background:

  • Essential hyperhidrosis is a condition characterized by excessive sweating.
  • Resectional surgery of sympathetic nerves is an established treatment.
  • Thoracoscopic electrocauterization offers a minimally invasive approach with reduced morbidity.

Purpose of the Study:

  • To describe the experience with thoracoscopic sympathetic surgery for essential hyperhidrosis.
  • To evaluate the effectiveness and safety of evolving minimally invasive techniques.
  • To assess patient satisfaction rates and complication incidence.

Main Methods:

  • Retrospective analysis of 1,167 patients undergoing thoracoscopic sympathetic surgery from July 1992 to March 1999.

Related Experiment Videos

  • Procedures included T2-4 sympathectomy, T3/T2 clipping (palmar/craniofacial), and T3,4 sympathicotomy (axillary) using a 2 mm needle thoracoscope.
  • Evolution towards less invasive procedures with limited resection and newer endoscopic devices.

    • Main Results:

    • High long-term satisfaction rates: 98% (palmar), 92% (craniofacial), 89% (axillary).
    • Decreased operation time and complications (e.g., Horner's syndrome, compensatory hyperhidrosis) with less invasive methods.
    • Successful reoperation for recurrent cases (14/1167).

    Conclusions:

    • Optimizing therapy involves complete symptom elimination, reduced compensatory hyperhidrosis via selective resection, and minimally invasive approaches.
    • Sympathicotomy offers limited denervation and less compensatory sweating than sympathectomy.
    • Clipping is a potentially reversible option; T2 clipping/sympathicotomy and T3,4 sympathicotomy show superiority for craniofacial and axillary hyperhidrosis, respectively.