Hyperhidrosis treated by thoracoscopic sympathicotomy.
Hyperhidrosis of the palms, axillae and face has a strong negative impact on social and professional life. The existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. A definitive cure can be obtained by upper thoracic sympathectomy. The traditional open surgical techniques are major procedures and few patients and surgeons have found that the risk--benefit consideration favoured surgery. Since 1987, the authors have divided the upper thoracic sympathetic chain on 1163 patients with a simple endoscopic technique by using standard urological equipment. A bilateral procedure takes less than 20 min and requires just one night in hospital. There have been no mortality or life-threatening complications. Ten patients (< 1%) required intercostal drainage because of haemo- or pneumothorax. Horner's syndrome occurred in four cases. Primary failure occurred in 23 cases (< 2%) and 24 (< 2%) developed recurrent symptoms. The patients with failure and recurrence were successfully reoperated on and only three have required a third operation. At the end of postoperative follow-up (median 31 months) 98% of the patients were satisfied. Endoscopic transthoracic sympathicotomy is an efficient, safe and minimally invasive surgical method for the treatment of palmar, axillary and facial hyperhidrosis.
Drott
C
C
Department of Surgery, Borås Hospital, Sweden.
Claes
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004564:Electrocoagulation; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013546:Sweating; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013906:Thoracoscopy; D016896:Treatment Outcome