Compensatory sweating after thoracoscopic sympathectomy: an acceptable trade-off.

Area of Science:

• Thoracic surgery
• Dermatology
• Quality of Life Studies

Background:

• Palmar hyperhidrosis is a prevalent condition.
• Thoracoscopic sympathectomy (TS) is an effective treatment for palmar hyperhidrosis.
• Compensatory sweating (CS) is a significant side effect of TS.

Purpose of the Study:

• To assess the long-term efficacy and patient satisfaction following TS for palmar hyperhidrosis.
• To investigate the natural history and impact of compensatory sweating (CS).
• To determine patient willingness to undergo TS in retrospect, considering CS.

Main Methods:

• A retrospective chart review identified 621 patients with >24 months follow-up after TS.
• A telephone questionnaire was administered to 265 (43%) of these patients.
• Data collected included symptom relief, satisfaction, CS severity, and retrospective decision.

Main Results:

• 97% of patients reported complete or reasonable symptomatic relief from hyperhidrosis.
• Long-term postoperative satisfaction was high at 84.5%.
• 41% experienced a moderate to severe decrease in quality of life due to CS, with adults more likely to regret the surgery than children (31.4% vs 8.8%). CS severity remained stable in 70% of patients over time.

Conclusions:

• TS provides significant long-term relief for palmar hyperhidrosis.
• Patients generally prefer hyperhidrosis relief over the burden of CS.
• Early intervention with TS is recommended, as hyperhidrosis is not self-limiting.