title: Impact of compensatory hyperhidrosis on patient satisfaction after endoscopic thoracic sympathectomy.
abstract: OBJECTIVE
  Endoscopic thoracic sympathectomy (ETS) remains the definitive treatment for primary focal hyperhidrosis. Compensatory hyperhidrosis (CH) is a significant drawback of ETS. We sought to identify the predictors for the development of severe CH after ETS, its anatomic locations, and its frequency of occurrence, and we analyzed the impact of CH on patient satisfaction with ETS.
  
  
  METHODS
  Bilateral ETS for primary focal hyperhidrosis was performed in 220 patients, and a retrospective chart review was conducted. Follow-up evaluation was conducted using a telephone questionnaire, and 73% of all patients were contacted. Patients' responses regarding CH and their level of satisfaction after ETS were analyzed. Statistical analysis was performed using SPSS software (Version 14.0; SPSS, Inc., Chicago, IL). A P value of <0.05 was considered statistically significant.
  
  
  RESULTS
  Some degree of CH developed in 94% of patients. The number of levels treated was not related to the occurrence of severe CH. Isolated T3 ganglionectomy led to a significantly lower incidence of severe CH, when compared with all other levels (P < 0.03). Ninety percent of patients were satisfied with the procedure. The development of severe CH, as opposed to mild or moderate CH, significantly correlated with a lower satisfaction rate (P = 0.003).
  
  
  CONCLUSIONS
  CH is common after ETS procedures, and the occurrence of severe, but not mild or moderate, CH is a major source of dissatisfaction after ETS. The overall occurrence of severe CH is reduced after T3 ganglionectomy as opposed to ganglionectomies performed at all other levels. The level of satisfaction with ETS is high.
authors.affiliation: Department of Neurological Surgery, Roosevelt Hospital, New York, New York 10019, USA. markusmd@earthlink.net
authors.forename: Mark
authors.initials: M
authors.lastname: Chwajol
authors.forename: Ignacio J
authors.initials: IJ
authors.lastname: Barrenechea
authors.forename: Shamik
authors.initials: S
authors.lastname: Chakraborty
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Lesser
authors.forename: Cliff P
authors.initials: CP
authors.lastname: Connery
authors.forename: Noel I
authors.initials: NI
authors.lastname: Perin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013562:Sympathectomy / Q000706:statistics & numerical data*; D013900:Thoracic Nerves / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult