Video-assisted thoracic sympathectomy in the treatment of primary hyperhidrosis: a retrospective study of 521 cases comparing different levels of ablation.
OBJECTIVE
To compare different levels of ablation in terms of the degree of patient satisfaction and extent of postoperative reflex sweating in sympathectomized patients.


METHODS
A retrospective study involving 521 patients with primary hyperhidrosis, submitted to thoracic sympathectomy at the Monte Sinai Hospital and University Hospital of the Federal University of Juiz de Fora, from January of 2001 to December 2005. All patients were submitted to thermal ablation of the sympathetic stem and were divided into three groups: up to T2 (group I, n = 162); up to T3 (group II, n = 65); and up to T4 (group III, n = 294).


RESULTS
Optimal postoperative control of palmar/axillary hyperhidrosis was achieved in, respectively, 94/82% of the patients of group I, 89/89% of those in group II and 80/80% of those in group III. Postoperative reflex sweating was observed in 67% of the patients in groups I and II, compared with 61.29% of those in group III. Severe reflex sweating occurred in 32% of the group I patients, 9% of the group II patients and 4% of the group III patients.


CONCLUSIONS
Sympathectomy provided excellent patient satisfaction and a low incidence of complications. There was no significant difference between the levels of ablation in terms of reflex sweating, although the intensity of this complication decreased when lower levels of blockage, principally at the T4 level, were employed.
Montessi
Jorge
J
Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil. jmontessi@terra.com.br
Almeida
Edmílton Pereira de
EP
Vieira
João Paulo
JP
Abreu
Marcus da Matta
Mda M
Souza
Renato Lucas Passos de
RL
Montessi
Oswaldo Victor Duarte
OV
D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012018:Reflex / Q000502:physiology; D012189:Retrospective Studies; D013546:Sweating / Q000502:physiology; D013562:Sympathectomy / Q000379:methods*; D013900:Thoracic Nerves / Q000601:surgery; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome