Upper thoracic sympathectomy for primary palmar hyperhidrosis: long-term follow-up

Area of Science:

• Medical research
• Surgical innovation
• Patient outcomes

Background:

• Primary palmar hyperhidrosis significantly impacts daily life and social interactions.
• Upper thoracic sympathectomy is recognized as the most effective curative treatment for palmar hyperhidrosis.
• Various surgical techniques exist, with ongoing development in less invasive methods.

Purpose of the Study:

• To evaluate the long-term efficacy and patient satisfaction of the supraclavicular approach for upper thoracic sympathectomy.
• To compare the outcomes of this surgical method with other available treatments for palmar hyperhidrosis.
• To assess the failure and recurrence rates associated with the procedure.

Main Methods:

• A series of 170 upper thoracic sympathectomies were performed using the supraclavicular approach on 85 patients.
• Long-term follow-up data were collected for 124 operated limbs, averaging 8.3 years.
• Patient satisfaction and specific adverse outcomes were systematically recorded.

Main Results:

• The immediate failure rate for hyperhidrosis relief was 2.4%.
• Recurrence of hyperhidrosis was observed in 4.1% of limbs within 2 to 18 months post-surgery.
• Overall patient satisfaction was approximately 87%, with dissatisfaction attributed to persistent symptoms or complications like Horner's syndrome.

Conclusions:

• The supraclavicular approach to upper thoracic sympathectomy provides rewarding, long-term results for the majority of patients with palmar hyperhidrosis.
• The study underscores the need for comparative analysis of long-term outcomes across different surgical techniques.
• Further data on alternative methods like percutaneous phenol injection and transthoracoscopic sympathectomy are needed for comprehensive treatment evaluation.