Thoracoscopic Sympathicotomy vs Sympathectomy in Primary Hyperhidrosis

Area of Science:

• Thoracic surgery
• Surgical innovation
• Hyperhidrosis treatment

Background:

• Primary hyperhidrosis (P.H.H.) involves excessive sweating, affecting 0-6.1% globally and 3% in Asian populations.
• A positive family history is noted in 57% of P.H.H. cases.
• P.H.H. significantly impacts quality of life, necessitating effective treatment options.

Purpose of the Study:

• To compare thoracoscopic sympathectomy and sympathicotomy for P.H.H. treatment.
• To evaluate early and late patient satisfaction, surgical outcomes, and complications.
• To determine the optimal surgical approach for primary hyperhidrosis.

Main Methods:

• Prospective study of 60 P.H.H. patients from April 2007 to January 2011.
• 30 patients underwent thoracoscopic sympathectomy, and 30 underwent sympathicotomy.
• Outcomes assessed at 5-8 days and 12 months post-surgery.

Main Results:

• Sympathicotomy had a significantly shorter mean operative time (66.3 min) vs. sympathectomy (110.8 min).
• No significant differences in satisfaction, gustatory sweating, pompholyx, or post-operative pain.
• Sympathicotomy showed less compensatory sweating (C.S.) and related adverse effects.

Conclusions:

• Sympathicotomy appears superior to sympathectomy for P.H.H.
• Reduced operative time and less compensatory sweating favor sympathicotomy.
• Further research may solidify sympathicotomy as a preferred P.H.H. surgical treatment.