Sympathotomy for palmar hyperhidrosis: the cutting versus clamping methods.

Area of Science:

• Thoracic surgery
• Neurosurgery
• Dermatology

Background:

• Palmar hyperhidrosis is a condition causing excessive sweating in the palms.
• Endoscopic thoracic sympathectomy/sympathotomy (ETS) is a surgical treatment for palmar hyperhidrosis.
• ETS involves interrupting the sympathetic nerve chain, typically at the T3 level.

Purpose of the Study:

• To compare the efficacy and side effects of cutting versus clamping the sympathetic chain at T3 during ETS for palmar hyperhidrosis.
• To evaluate postoperative palmar sweating, compensatory sweating, and patient satisfaction between the two surgical techniques.

Main Methods:

• A retrospective study of 289 patients who underwent bilateral T3 sympathotomy for palmar hyperhidrosis.
• 92 patients responded to a mailed questionnaire assessing palmar sweating, compensatory sweating, and satisfaction.
• Patients were divided into a cutting group (n=54) and a clamping group (n=38).

Main Results:

• The cutting group showed significantly lower postoperative palmar sweating compared to the clamping group.
• Compensatory sweating was significantly more severe in the cutting group than in the clamping group.
• No significant difference in patient satisfaction was found between the cutting and clamping groups.

Conclusions:

• Sympathotomy by cutting at T3 is more effective in reducing palmar sweating but causes more compensatory sweating than clamping.
• Both cutting and clamping methods yield similar patient satisfaction levels.
• Reduced palmar sweating and less compensatory sweating correlate inversely with patient satisfaction.