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[Efficacy comparison of two methods of r3 sympathicotomy for palmar hyperhidrosis]
Min Lin1, Yuanrong Tu1, Jianfeng Chen1
1Department of Thoracic Surgery, First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China.
Objective:
To explore the necessity of interrupting nerve fibers of bypass thoracic sympathetic chain during edoscopic sympathicotomy (ETS) for palmar hyperhidrosis.
Methods:
Randomized controlled trial was performed for 200 patients of severe palmar hyperhidrosis from January 2009 to June 2011. They were randomly divided into 2 groups of R3 thoracic sympathctomy (R3) and R3 thoracic sympathicotomy plus bypass fiber resection at the same level (R3+) (n = 100 each). Clinical observations were recorded during a follow-up period of 3 years.
Results:
The curative rates of palmar and axillary hyperhidrosis were 100% for two groups. No statistically significant inter-group difference existed in left hand temperature increase after transecting thoracic sympathetic nerve (3.6 ± 1.4 °C vs 3.5 ± 1.3 °C), right hand increase (3.8 ± 1.3 °C vs 3.9 ± 1.1 °C), incidence of compensatory hyperhidrosis (40% vs 44%), recurrence rate (1% vs 2%) and postoperative satisfaction rate (92% vs 90%). But pain scores of R3 group was significantly lower than those of R3+ group (3.0 ± 1.9 vs 3.6 ± 1.9, P < 0.05).
Conclusion:
Simple transaction of thoracic sympathetic chain during ETS is sufficient in the treatment of palmar hyperhidrosis. And it is unnecessary to transect bypass fibers.
