title: Thoracoscopic excision of the sympathetic chain: an easy and effective treatment for hyperhidrosis in children.
abstract: BACKGROUND
  Thoracoscopic sympathectomy (TS) is an effective treatment for hyperhidrosis. Various surgical approaches are described in the literature. We describe the technique of thoracoscopic excision of the sympathetic chain done exclusively in children younger than 13 years.
  
  
  METHODS
  All patients younger than 13 years who underwent TS from 2006 at a single institution were prospectively identified and fully evaluated with emphasis on demographic data, age, surgical management, complications and follow-up. All patients were contacted again at the end of 2009 to complete a follow-up questionnaire.
  
  
  RESULTS
  Twelve patients underwent TS between 2006 and 2009. Age ranged from 6 to 13 years. This involved T2-T3 excision for nine patients with isolated palmar hyperhidrosis, and T2-T3-T4 excision for three with additional axillary hyperhidrosis. Six underwent bilateral TS at the same session and six underwent unilateral TS for the dominant side. Four of them had their contralateral operation performed 2-3 months later. Dry limbs were immediately achieved in all patients. Compensatory sweating (CS) was noted in eight patients. Complications included transient ptosis in two and mild recurrence in one.
  
  
  CONCLUSIONS
  Thoracoscopic excision of the sympathetic chain is a simple and safe procedure that relieves hyperhidrosis in all cases and significantly improves the quality of life.
authors.affiliation: Ain Shams University, Cairo, Egypt. mshalaby@doctors.org.uk
authors.forename: Mohamed Sameh
authors.initials: MS
authors.lastname: Shalaby
authors.forename: Ehab
authors.initials: E
authors.lastname: El-Shafee
authors.forename: Hesham
authors.initials: H
authors.lastname: Safoury
authors.forename: Sameh Abd
authors.initials: SA
authors.lastname: El Hay
mesh_terms: D000293:Adolescent; D001365:Axilla / Q000294:innervation*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome