Endoscopic thoracic sympathetic block by clipping for recurrent palmar hyperhidrosis

Area of Science:

• Thoracic Surgery
• Neurosurgery
• Dermatology

Background:

• Recurrent palmar hyperhidrosis can significantly impact quality of life.
• Endoscopic thoracic sympathectomy (ETS) is a common treatment, but complications like compensatory sweating can occur.
• Alternative or refined sympathetic block techniques are needed.

Purpose of the Study:

• To evaluate the safety and efficacy of video-assisted thoracoscopic T2 and T3 sympathetic block for recurrent palmar hyperhidrosis.
• To assess the outcomes and recurrence rates of this minimally invasive procedure.

Main Methods:

• 16 patients with recurrent palmar hyperhidrosis underwent video-assisted thoracoscopic T2 and T3 sympathetic block between 1998 and 2002.
• The procedure involved T2 sympathetic block, with an additional T3 block if necessary, using a thoracoscope.
• Patients were monitored for improvement in hyperhidrosis and complications.

Main Results:

• All 16 patients experienced improvement in palmar hyperhidrosis.
• The mean operation time was 30 minutes.
• One patient underwent a reverse operation for compensatory sweating and achieved dry hands post-removal of clips. No recurrence was noted after a mean follow-up of 37.1 months.

Conclusions:

• Endoscopic thoracic T2 with or without T3 sympathetic block by clipping is a safe and effective treatment for recurrent palmar hyperhidrosis.
• The procedure demonstrates a low complication rate and provides long-term relief.
• This technique offers a viable alternative for managing persistent palmar hyperhidrosis.