Complications of video assisted thoracoscopic sympathectomy for primary hyperhidrosis

To document the possible complications of video-assisted thoracoscopic sympathectomy procedure and their frequency of occurrence.

This retrospective study was conducted at King Hussein Medical Center, Amman, Jordan, between April 2001 and January 2006. Two hundred and seven patients underwent thoracoscopic sympathectomy for the treatment of facial, axillary, and/or palmar hyperhidrosis. Follow up was completed for one year. All possible early and late complications were documented and analyzed.

Males constituted 59.4% of the studied patients. Mean age (range) was 25.2+/-4.6 (13-34) years. One hundred and fifty-three patients (73.9%) had palmar hyperhidrosis as the main indication for sympathectomy, 4 patients (1.9%) had axillary hyperhidrosis, and facial sweating or blushing in 7 patients (3.4%). Palmar hyperhidrosis combined with axillary and/or facial sweating were found in 43 patients (20.8%). The most common recorded complication was compensatory hyperhidrosis, which occurred in 142 patients (68.6%).

Compensatory sweating remains the most common, and most disabling complication of video-assisted thoracoscopic sympathectomy. Other alternative more selective methods, rather than cutting the main trunk should be studied thoroughly to assess their efficacy in reducing the complication of compensatory sweating.