title: [Evaluation of the long-term results of surgical treatment of palmar hyperhidrosis].
abstract: BACKGROUND
  Palmar hyperhidrosis (PH) is a relative frequent pathology which basically affects patients' life quality limiting social and laboral life. The treatment of choice is thoracoscopic sympathectomy, most frequently done during adulthood. The aim of our study was to evaluate the degree of satisfaction of the pediatric patients treated in our centre.
  
  
  METHODS
  We retrospectively reviewed the clinical records of the patients controlled and treated in our centre during the last 4 years evaluating the symptoms before surgery, the level of the sympathectomy and postoperative complications. To evaluate the long-term results we developed a telephone questionnaire for all the patients centralized on the grade of satisfaction, the efficiency of the treatment, the compensatory sweating and the observed changes in life quality. The medium follow-up time was 26.5 months (rango 6 months to 4 years).
  
  
  RESULTS
  In total 6 patients were reviewed (4 female, 2 male), medium age 12, 8 years (rango 8 to 18 years). Thoracoscopic sympathectomy was done at the level of T2 or T3 associating T4 in 1 case. We just observed 1 postoperative complication which consisted in a disestesia of the upper extremity and which disappeared spontaneously without sequels. Patients referred total relief of palmar sweating. Only 1 case reported residual sweating unilaterally in the tenar region, but in all of them sweating of feet still persisted (3 of low grade and 3 of moderate grade). In 50% of the cases we observed compensatory sweating localized at the back of moderate grade in 2 patients and at the upper legs of more severe grade in 1 of them. Only this last patient reported that the compensatory sweating affected his everyday life. We also observed that the patients where the sympathectomy had affected more than 1 ganglia (T2+T3; T3+T4; T2+T3+T4) referred a higher grade of compensatory sweating. All the cases reported an important improvement in life quality, in the social as in the formative manner. They were all very satisfied with the results of the surgery and none of them (neither the children nor the parents) regretted the intervention. The cosmetic result of the surgical scars was also satisfactory.
  
  
  CONCLUSIONS
  The thoracoscopic sympathectomy is an efficient procedure for the treatment of palmar hyperhidrosis. Despite the compensatory sweating patients usually are very satisfied with the results. Since palmar hyperhidrosis is not a pathology which improves spontaneously and the surgical treatment has minimal complications we do not think that the surgery should be postponed in pediatric patients.
authors.affiliation: Hospital Materno-lnfantil Gregorio Marañón, Madrid. alfhiler@yahoo.es
authors.forename: A
authors.initials: A
authors.lastname: Laín
authors.forename: M A
authors.initials: MA
authors.lastname: García-Casillas
authors.forename: M
authors.initials: M
authors.lastname: Fanjul
authors.forename: C
authors.initials: C
authors.lastname: Corona
authors.forename: A
authors.initials: A
authors.lastname: Tardáguila
authors.forename: J A
authors.initials: JA
authors.lastname: Matute
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006229:Hand Dermatoses / Q000601:surgery*; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome