A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis.
OBJECTIVE
Endoscopic thoracic sympathetic surgery is effective for treating palmar hyperhidrosis, although compensatory sweating (CS) is a significant and annoying side effect. The purpose of this study was to compare the results of limited resection at two different locations.


METHODS
From May 2004 to June 2009, T3 sympathicotomy (group I) was performed in 46 patients and T3,4 ramicotomy (group II) was performed in 43 patients during the same period. T3 sympathicotomy (group I) and T3,4 ramicotomy (group II) were performed during the same period. Using questionnaires, completed by the patients, the satisfaction rates and grades of CS were analyzed.


RESULTS
No significant differences in age distribution or sex ratios were observed between the two groups. The satisfaction rate was 91.3 % in group I and 79.1 % in group II. The operation time was 19.8 (±6.6) min in group I, and 51.6 (±18.8) min in group II, showing a statistically significant difference (p < 0.002). The incidence of persistent hand sweating in group II (16.3 %) was higher than that observed in group I (2.2 %). The incidence of compensatory sweating on the lower extremities was higher in group II (37.2 %) than in group I (10.9 %).


CONCLUSIONS
Although ramicotomy is considered to be an effective method for treating hyperhidrosis and has a theoretical advantage of allowing greater anatomical resection, it requires longer operation time and induces more severe compensatory sweating in the lower limbs resulting in reduced satisfaction rates.
Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Daejeon, Korea.
Jung Joo
JJ
Hwang
Do Hyung
DH
Kim
Yoon Joo
YJ
Hong
Doo Yun
DY
Lee
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D061646:Operative Time; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D013562:Sympathectomy / Q000379:methods*; D013900:Thoracic Nerves / Q000601:surgery*; D013906:Thoracoscopy; D016896:Treatment Outcome