Extended thoracoscopic T2-sympathectomy in treatment of hyperhidrosis: experience with 130 consecutive cases

A new method of thoracoscopic T2-sympathectomy mentioned in a previous report was used on 36 cases of hyperhidrosis at Tainan Municipal Hospital in Taiwan between October 1, 1989 and July 31, 1990. To reduce the possibility of incomplete resection of sympathetic nerve tracts, including ganglions and their regeneration, the method was modified on August 1, 1990. Thereafter, routine total removal of T2 and T3 sympathetic ganglions, as well as wide lateral incisions of the pleura on the second, third, and fourth rib beds were performed for treatment of hyperhidrosis. This newly modified method, "extended thoracoscopic T2-sympathectomy," can be performed easily by thoracoscopic approach in the treatment of hyperhidrosis palmaris. From August 1, 1990 to May 31, 1991, 130 consecutive cases of hyperhidrosis (56 males and 74 females) ranging in age from 8 to 51 years underwent extended thoracoscopic T2-sympathectomy. In addition to a nearly 100% cure rate of hyperhidrosis palmaris, significant saving in operative time and hospital stay were achieved. High simultaneous cure rate (70.6%) and subjective improvement (17.4%) of excessive sweating of feet (hyperhidrosis plantaris) were also noted in the 109 cases followed up, and complications were minor. Extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective method in the treatment of hyperhidrosis. It is worthy of being propagated worldwide.