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Resympathectomy for palmar and axillary hyperhidrosis

C P Hsu1, C Y Chen, J Y Hsia

  • 1Department of Surgery, Taichung Veterans General Hospital, Taiwan, Republic of China.

The British Journal of Surgery
|November 21, 1998
PubMed
Summary
This summary is machine-generated.

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Recurrent hyperhidrosis after sympathectomy is often due to inadequate surgery, not nerve regeneration. Repeat sympathectomy (resympathectomy) can effectively treat these cases, restoring symptom relief for most patients.

Area of Science:

  • Thoracic surgery
  • Neurosurgery
  • Dermatology

Background:

  • Primary sympathectomy for hyperhidrosis can fail, leading to symptom recurrence.
  • Understanding failure patterns is crucial for improving surgical outcomes.

Purpose of the Study:

  • To analyze failure patterns after primary sympathectomy for palmar/axillary hyperhidrosis.
  • To evaluate the effectiveness of resympathectomy for recurrent symptoms.
  • To review operative findings during resympathectomy.

Main Methods:

  • Retrospective analysis of 20 patients undergoing resympathectomy over 2 years.
  • Procedures included T2-3 sympathectomy for palmar or T4-5 for axillary hyperhidrosis.
  • Patient questionnaires assessed improvement (good, fair, poor).

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Main Results:

  • Inadequate sympathectomy was found in 19 sides; nerve regeneration in 8.
  • Resympathectomy achieved good results in all 13 palmar hyperhidrosis patients (20 sides).
  • Good results were seen in 6/7 palmar hyperhidrosis patients (8/10 sides) after resympathectomy.

Conclusions:

  • Inadequate primary surgery is the main cause of sympathectomy failure.
  • Nerve regeneration is an infrequent cause of recurrent hyperhidrosis.
  • Accurate and adequate primary sympathectomy is key; resympathectomy offers a cure for most recurrent cases.