Endoscopic thoracic sympathectomy for primary palmar hyperidrosis.

Area of Science:

• Cardiothoracic Surgery
• Neurosurgery
• Dermatology

Background:

• Primary hyperhidrosis is excessive sweating unrelated to thermoregulation, impacting social and professional life.
• Commonly affects palms, armpits, soles, and face, often exacerbated by emotions and heat.
• Existing treatments include topical agents, iontophoresis, medications, botulinum toxin, and surgical options.

Purpose of the Study:

• To evaluate the efficacy and safety of video-assisted thoracoscopic T3 sympathectomy for palmar hyperhidrosis.
• To assess the impact of the procedure on patients' quality of life.
• To document postoperative outcomes and side effects.

Main Methods:

• A prospective study of 322 patients undergoing bilateral video-assisted thoracoscopic T3 sympathectomy between 1998 and 2007.
• Data collected via case histories and pre- and postoperative questionnaires.
• Statistical analysis using paired t-test and Wilcoxon test.

Main Results:

• Immediate cessation of palmar hyperhidrosis in all patients.
• Significant improvement in quality of life reported.
• Compensatory sweating occurred in 63% of patients (29% if mild cases excluded), the most common side effect.

Conclusions:

• Endoscopic thoracic sympathectomy is a safe and effective treatment for palmar hyperhidrosis with low morbidity and zero mortality.
• The procedure leads to high patient satisfaction and minimal recurrence rates (1%).
• Recommended as a primary treatment option for palmar hyperhidrosis.