[Selective endoscopic sympathectomy for palmar hyperhidrosis].
OBJECTIVE
Thoracic sympathectomy is the radical and usually definite treatment of palmar hyperhidrosis. Improvement of surgical endoscopy techniques makes it possible to perform the procedure through thoracoscopy, thus minimizing operative trauma and sequellae. However, thoracic sympathectomies give rise to a high rate of compensatory sweating which is the most important adverse effect of the technique.


METHODS
We developed a technique of selective sympathectomy which only divides the rami communicanti from the first to the fourth thoracic ganglion. We performed 90 thoracic sympathectomies in 46 patients. They were performed in a truncal manner in 32 patients while it was selective in the last 14 patients.


RESULTS
The success rate was 97.5% (2 failures). After reoperation of these 2 failures, the success rate was 100%. The global rate of compensatory sweating was 47.5%. In the 14 last patients who underwent a selective sympathectomy, only one complained of compensatory sweating.


CONCLUSIONS
Endoscopic sympathectomy is an effective means of treating palmar hyperhidrosis. Rigorous technique should help reduce the risk of compensatory sweating.
Gossot
D
D
Service de Chirurgie, Hôpital Saint-Louis, Paris.
D000328:Adult; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013562:Sympathectomy / Q000379:methods*; D013900:Thoracic Nerves / Q000601:surgery*; D013906:Thoracoscopy
Sympathectomie sélective endoscopique pour hyperhidrose palmaire.