title: Experiences in thoracoscopic sympathectomy for axillary hyperhidrosis and osmidrosis: focusing on the extent of sympathectomy.
abstract: OBJECTIVE
  A more selective sympathectomy can improve the outcome of axillary hyperhidrosis and osmidrosis and minimize the potential sequelae.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  Between July 1, 1996, and May 30, 2000, 171 patients with axillary hyperhidrosis and osmidrosis were studied.
  
  
  METHODS
  T3-4 sympathectomies were performed in 40 patients (group 1), T4 sympathectomies were performed in 56 patients (group 2), and T4-5 sympathectomies were performed in 75 patients (group 3).
  
  
  METHODS
  The surgical outcomes were evaluated by direct patient interview in the outpatient clinic or by telephone or mail questionnaires. The results were categorized as excellent (significant or complete disappearance of symptoms), good (>/=50% improvement), or poor (<50% improvement).
  
  
  RESULTS
  There were no surgical mortalities in this study. Twenty-eight group 1 patients (70%), 16 group 2 patients (29%), and 22 group 3 patients (29%) developed compensatory perspiration (P<.001). Six group 1 patients (15%), 1 group 2 patient (2%), and 1 group 3 patient (1%) developed dry hands (P =.02). In the group 1 patients, the surgical outcomes were excellent in 21 (52%), good in 6 (15%), and poor in 13 (32%). In the group 2 patients, the surgical outcomes were excellent in 29 (52%), good in 10 (18%), and poor in 17 (30%). In the group 3 patients, the surgical outcomes were excellent in 53 (71%), good in 11 (15%), and poor in 11(15%) (P =.04). (Percentages may not sum to 100 because of rounding.)
  
  
  CONCLUSIONS
  T4-5 sympathectomies provide higher patient satisfaction rates in treating axillary hyperhidrosis and osmidrosis, with fewer sequelae.
authors.affiliation: Division of Surgical Emergency, Taichung Veterans General Hospital, Building 160, Section 3, Taichung-Kang Road, Taichung, Taiwan. cliff@vghtc.vghtc.gov.tw
authors.forename: C P
authors.initials: CP
authors.lastname: Hsu
authors.forename: S E
authors.initials: SE
authors.lastname: Shia
authors.forename: J Y
authors.initials: JY
authors.lastname: Hsia
authors.forename: C Y
authors.initials: CY
authors.lastname: Chuang
authors.forename: C Y
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D001365:Axilla; D002648:Child; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods; D013906:Thoracoscopy