Thoracoscopic resympathectomy for persistent or recurrent palmar hyperhidrosis: single-center experience

Area of Science:

• Thoracic surgery
• Neurosurgery
• Dermatology

Background:

• Palmar hyperhidrosis recurrence or persistence often necessitates further intervention.
• Surgeons hesitate to reoperate due to unpredictable outcomes of sympathetic chain resection.
• Analysis of a large patient series undergoing resympathectomy is presented.

Purpose of the Study:

• To evaluate the efficacy and outcomes of resympathectomy for recurrent or persistent palmar hyperhidrosis.
• To assess the safety profile of repeat sympathetic chain resection.
• To inform surgical decision-making for complex hyperhidrosis cases.

Main Methods:

• Retrospective analysis of 39 patients who underwent bilateral sympathetic chain Th2-3 resection (resympathectomy).
• Inclusion criteria: patients referred for or initially operated for recurrent/persistent palmar hyperhidrosis.
• Minimally invasive surgical approach utilized.

Main Results:

• No intraoperative complications were observed.
• Two patients required reoperation or chest tube placement.
• Twenty-eight patients (72%) reported excellent or good outcomes.
• Seven patients (18%) experienced partial symptom reduction.
• Four patients (10%) were unsatisfied with the results.

Conclusions:

• Resympathectomy demonstrates high effectiveness for managing persistent or recurrent palmar hyperhidrosis.
• Careful patient selection and dissuasive indications are recommended to mitigate risks of undesirable psychological side effects.
• This procedure offers a viable option for carefully selected patients with refractory hyperhidrosis.