title: Quality of life, before and after thoracic sympathectomy: report on 378 operated patients.
abstract: BACKGROUND
  Thoracic sympathectomy is indicated to treat primary hyperhidrosis. The objective is to analyze the results and complications of thoracic sympathectomy and propose a questionnaire to assess the quality of life of patients.
  
  
  METHODS
  Between October 1995 and March 2002, 378 patients were evaluated. Sixty-two percent were female, with a mean age of 26.8 years old (range 9 to 70 years old). There were 57.4% patients with palmar-plantar hyperhidrosis; 25% with palmar, plantar, and axillary hyperhidrosis; 15.7% with pure axillary hyperhidrosis; and 6.5% with craniofacial hyperhidrosis. General anesthesia was used in 97.3%, epidural with sedation in 2.7%. The sympathetic chain was resected in 12.5%, thermal ablation with the electrical scalpel was performed in 66.3%, and with the harmonic scalpel in 21.2% of the patients.
  
  
  RESULTS
  Successful sympathectomies were performed in 90.3% of the patients; the follow-up was from 1 to 60 months (mean 12.4 +/- 8.3 months). The recurrence rates were 8.2% for palmar hyperhidrosis, 13.7% for pure axillary hyperhidrosis, 27.5% of which were reoperated successfully. Improvement of the plantar hyperhidrosis was also registered in 58%. Horner's syndrome was reported in 1% with regression in half of them after 30 days. No mortality or serious complications were observed, nor the need to convert to thoracotomy. Of the total number of patients, 93.4% answered the quality of life questionnaire, 86.4% of whom noted improvement after the procedure.
  
  
  CONCLUSIONS
  Thoracic sympathectomy is a simple, effective, safe method for the treatment of hyperhidrosis, resulting in an improved quality of life for patients. The questionnaire documents this change.
authors.affiliation: Division of Thoracic Surgery Division of Vascular Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. jribas@usp.br
authors.forename: José Ribas Milanez
authors.initials: JR
authors.lastname: de Campos
authors.forename: Paulo
authors.initials: P
authors.lastname: Kauffman
authors.forename: Eduardo de Campos
authors.initials: Ede C
authors.lastname: Werebe
authors.forename: Laert Oliveira
authors.initials: LO
authors.lastname: Andrade Filho
authors.forename: Sergio
authors.initials: S
authors.lastname: Kusniek
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: Fábio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*