title: Bilateral thoracoscopic sympathectomy: results and long-term follow-up.
abstract: The aim of this study is to evaluate the efficacy of bilateral thoracoscopic sympathectomy in alleviating symptoms and improving quality of life in patients with hyperhidrosis or facial blushing and to investigate the occurrence, severity and possible underlying factors to compensatory sweating after surgery. One hundred and sixty-three patients in a single institution underwent bilateral thoracoscopic sympathectomy with a mean follow-up period of 51 (5-140) months. Indications were for palmar hyperhidrosis (41%), axillary hyperhidrosis (17%), combined palmar and axillary hyperhidrosis (27%) and facial blushing+/-facial hyperhidrosis (15%). Success rates were palmar 98.5%, axillary 96.4%, palmar and axillary 97.7% and facial blushing+/-facial hyperhidrosis 84%. Compensatory sweating occurred in 77% of patients and its severity was related to the severity of the primary complaint. Recurrence rates were palmar 4.6%, axillary 7.4%, palmar and axillary 9.3% and facial blushing+/-facial hyperhidrosis 4.7% at a mean of 22 (3-72) months. An improvement in quality of life was seen in 85% and a diminution of quality of life was noted in 5% due to compensatory sweating. This large mature series demonstrates that bilateral thoracoscopic division of the sympathetic chain as opposed to resection can be performed effectively in patients with success rates higher than 90% and low recurrence rates.
authors.affiliation: Department of Thoracic Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK. reubenj@hotmail.com
authors.forename: Reubendra
authors.initials: R
authors.lastname: Jeganathan
authors.forename: Simon
authors.initials: S
authors.lastname: Jordan
authors.forename: Mark
authors.initials: M
authors.lastname: Jones
authors.forename: Stephen
authors.initials: S
authors.lastname: Grant
authors.forename: Owen
authors.initials: O
authors.lastname: Diamond
authors.forename: Kieran
authors.initials: K
authors.lastname: McManus
authors.forename: Alastair
authors.initials: A
authors.lastname: Graham
authors.forename: Jim
authors.initials: J
authors.lastname: McGuigan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000523:psychology / Q000601:surgery*; D007367:Intercostal Nerves / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome