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Thoracoscopic sympathectomy for palmar hyperhidrosis. Ablate or resect?

M Hashmonai1, A Assalia, D Kopelman

  • 1Department of Surgery B, The Rambam Medical Center and the Faculty of Medicine, Technion Israel Institute of Technology, P.O. Box 9621, Haifa 31096, Israel. hasmonai@inter.net.il

Surgical Endoscopy
|May 17, 2001
PubMed
Summary

Resection is a more effective surgical treatment for palmar hyperhidrosis than ablation, offering higher success rates and lower recurrence. While ablation is simpler, resection provides superior long-term outcomes for excessive sweating.

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Optimization of sympathectomy to treat palmar hyperhidrosis.

Surgical endoscopy·2013

Area of Science:

  • Thoracic surgery
  • Dermatology
  • Surgical techniques

Background:

  • Primary palmar hyperhidrosis is commonly treated with upper thoracoscopic sympathectomy.
  • Two main surgical techniques exist: ablation and resection of the sympathetic ganglia.
  • Comparing the efficacy of these sympathectomy methods is crucial for optimal patient care.

Purpose of the Study:

  • To compare the relative efficacy of ablation versus resection in thoracoscopic sympathectomy for primary palmar hyperhidrosis.

Main Methods:

  • A comprehensive Medline literature search was conducted.
  • Studies published between 1974 and 1999 were identified.
  • Identified studies were categorized into ablation and resection groups.

Main Results:

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  • Resection demonstrated a higher immediate success rate (99.76%) compared to ablation (95.2%).
  • Palmar sweating recurrence was 0% with resection versus -4.4% with ablation.
  • Ptosis (drooping eyelid) occurred in 1.72% after resection and 0.92% after ablation.

Conclusions:

  • Resection of sympathetic ganglia yields superior outcomes for palmar hyperhidrosis treatment.
  • Despite superior results, ablation is more frequently performed due to ease and shorter operating time.
  • Resection is recommended for better long-term efficacy in managing excessive palmar sweating.