Endoscopic thoracic sympathectomy for palmar hyperhidrosis: efficacy of T2 and T3 ganglion resection.
BACKGROUND
Endoscopic thoracic sympathectomy has been considered an effective treatment for palmar hyperhidrosis. However, the extent of resection has not been determined in terms of efficacy and complications. We compared the efficacy and complications of 2-ganglion and single-ganglion resection in patients with palmar hyperhidrosis.


METHODS
From 1995 to 2000, 75 patients underwent resection of thoracic ganglion T2 and T3. From 2000 to 2003, 67 patients underwent resection of only the T2 ganglion. Eighty of the 142 patients (56%) answered a detailed questionnaire, the results of which were analyzed.


RESULTS
Gender, age, family history, and distribution of sweating were similar in both groups. Recurrence rates 1 and 2 years after endoscopic thoracic ganglionectomy were between 0% and 3% in T2 and T3 resection, and between 15% and 19% in T2 resection only. In the combined T2 and T3 resection group, 100% of patients noticed compensatory sweating; in T2 resection, 90% of patients noticed compensatory sweating. As for rates of satisfaction, T2 and T3 resection was superior to T2 resection.


CONCLUSIONS
High recurrence rates of palmar hyperhidrosis after single-ganglion resection are reported in the present study. Two-ganglion resection is a superior surgical method to prevent recurrence of palmar hyperhidrosis.
Yano
Motoki
M
Department of Surgery II, Nagoya City University Graduate School of Medical Science, Japan. motoki@med.nagoya-cu.ac.jp
Kiriyama
Masanobu
M
Fukai
Ichiro
I
Sasaki
Hidefumi
H
Kobayashi
Yoshihiro
Y
Mizuno
Kotaro
K
Haneda
Hiroshi
H
Suzuki
Eriko
E
Endo
Katsuhiko
K
Fujii
Yoshitaka
Y
D000293:Adolescent; D000328:Adult; D004724:Endoscopy; D005260:Female; D005728:Ganglia, Sympathetic / Q000601:surgery*; D006225:Hand / Q000294:innervation; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D013562:Sympathectomy / Q000379:methods*; D013904:Thoracic Vertebrae