Does Sequential Thoracoscopic Sympathectomy Affect the Development of Postoperative Compensatory Sweating in...

Area of Science:

• Thoracic surgery
• Surgical innovation
• Hyperhidrosis management

Background:

• Compensatory sweating (CS) is a significant drawback of thoracoscopic sympathectomy (TS) for palmar hyperhidrosis (PH).
• Minimizing CS is crucial for improving patient outcomes after TS.
• Previous techniques to reduce CS include altering sympathectomy level or performing staged bilateral procedures.

Purpose of the Study:

• To compare the incidence and severity of postoperative compensatory sweating (CS) after sequential T3-T4 TS versus bilateral same-setting T3-T4 TS.
• To evaluate the safety and feasibility of these two surgical approaches for PH.

Main Methods:

• A comparative study included 38 patients (ages 5-18) with primary palmar hyperhidrosis.
• Group I (n=23) underwent sequential T3-T4 TS.
• Group II (n=15) underwent bilateral same-setting T3-T4 TS.

Main Results:

• No significant differences in sex or age distribution between groups.
• The rate of compensatory sweating was similar: 26% in sequential TS versus 33% in bilateral same-setting TS (p=0.77).
• No over-dryness or recurrence was observed in either group.

Conclusions:

• Sequential T3-T4 TS does not offer superior results in preventing compensatory sweating compared to bilateral same-setting T3-T4 TS.
• Bilateral same-setting T3-T4 TS is a safe and feasible option with advantages of shorter operative time, hospital stay, and cost.