Preserving T2 in thoracic sympathicotomy for palmar hyperhidrosis: less tissue trauma, same effectiveness

Area of Science:

• Thoracic surgery
• Neurosurgery
• Dermatology

Background:

• Primary hyperhidrosis is a condition causing excessive sweating.
• Endoscopic thoracic sympathicotomy (ETS) is a surgical option for hyperhidrosis.
• Compensatory sweating and complications are key concerns after ETS.

Purpose of the Study:

• To compare T2-3 sympathicotomy versus T3 sympathicotomy alone for primary hyperhidrosis.
• To evaluate differences in compensatory sweating, complications, safety, and effectiveness.
• To assess patient satisfaction with both surgical approaches.

Main Methods:

• Retrospective study of 78 patients undergoing bilateral ETS for palmar hyperhidrosis.
• Group A: T2-3 sympathicotomy (29 patients).
• Group B: T3 sympathicotomy alone (49 patients).
• Data collected on outcomes, side effects, complications, and satisfaction.
• Statistical analysis to compare the two groups.

Main Results:

• No significant difference in effectiveness, compensatory sweating, or complications between T2-3 and T3 sympathicotomy.
• Effectiveness was 100% at discharge and 97.5% at follow-up.
• No cases of Horner's syndrome or pneumothorax were detected.

Conclusions:

• Preserving the T2 ganglion (T3 sympathicotomy alone) is safe and effective for hyperhidrosis.
• This approach achieves similar success rates to sympathectomy with less tissue trauma.
• T3 sympathicotomy alone may offer advantages in reduced dissection and tissue injury.