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Endoscopic thoracic sympathectomy for hyperhidrosis shifts autonomic balance toward parasympathetic tone. Greater nerve resection led to more pronounced changes, with similar clinical outcomes between sympathectomy and sympathicotomy groups.

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Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Surgical Innovation

Background:

  • Essential palmar hyperhidrosis management often involves surgical intervention.
  • Cardiac autonomic function changes after sympathetic denervation require further investigation.

Purpose of the Study:

  • To evaluate cardiac autonomic changes in relation to the extent of sympathetic nerve resection for essential palmar hyperhidrosis.
  • To compare the effects of sympathectomy versus sympathicotomy on autonomic balance.

Main Methods:

  • Sixty patients with palmar hyperhidrosis were randomized into T3 ganglion excision (sympathectomy) or T2-T3 sympathetic chain interruption (sympathicotomy).
  • Cardiac autonomic function was assessed using 24-hour Holter monitoring (time and frequency domains) at baseline and multiple follow-up points.
  • Clinical outcomes were also evaluated for both surgical groups.

Main Results:

  • Both sympathectomy and sympathicotomy increased vagal activity and decreased adrenergic activity significantly.
  • These autonomic shifts were more pronounced in the sympathectomy group compared to the sympathicotomy group (p < 0.05).
  • Clinical outcomes were comparable between the two treatment groups.

Conclusions:

  • Endoscopic thoracic sympathectomy induces a shift in sympathovagal balance towards parasympathetic dominance.
  • The extent of sympathetic denervation correlates with the observed changes in autonomic balance.
  • Sympathectomy and sympathicotomy yield similar clinical results for hyperhidrosis management.