title: Thoracoscopic sympathectomy for palmar hyperhidrosis and Raynaud's phenomenon of the upper limb and excessive facial blushing: a five year experience.
abstract: Primary hyperhidrosis of the palms, face, and axillae has a strong negative impact on social and professional life. A retrospective analysis of 40 laparoscopic transaxillary thoracic sympathectomies performed in a district general hospital over a five year period was undertaken in order to determine the effectiveness of this procedure. A postal questionnaire was sent to all patients to assess the benefit from the operation; postoperative pain and time off work were collated. Immediate failure was noted in three patients, of whom two later underwent successful reoperation. Recurrence was noted in three patients (8%). Though immediate complications were minimal, the major long term postoperative morbidity was compensatory hyperhidrosis on the back, chest, and thigh (77%) along with gustatory sweating over the face (22%). Thoracoscopic sympathectomy is a safe, effective, and minimally invasive surgical treatment for hyperhidrosis, Raynaud's phenomenon of the upper limb, and excessive facial blushing; however, the chance of long term compensatory hyperhidrosis is high.
authors.affiliation: Royal Liverpool University Hospital, UK. rajyag@hotmail.com
authors.forename: Y S
authors.initials: YS
authors.lastname: Rajesh
authors.forename: C P
authors.initials: CP
authors.lastname: Pratap
authors.forename: A B
authors.initials: AB
authors.lastname: Woodyer
mesh_terms: D000293:Adolescent; D000328:Adult; D001821:Blushing; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D011182:Postoperative Care / Q000379:methods; D011928:Raynaud Disease / Q000601:surgery*; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome