title: Bilateral single-port sympathectomy: long-term results and quality of life.
abstract: OBJECTIVE
  Video-assisted thoracoscopic sympathectomy is a safe, effective, and minimally invasive procedure for primary hyperhidrosis. This study aims to evaluate long-term results and patients' quality of life and investigate potential variables responsible for compensatory sweating after one-stage bilateral single-port thoracoscopic sympathectomy.
  
  
  METHODS
  Between 2005 and 2011, 260 consecutive bilateral thoracoscopic sympathectomies were performed in 130 patients for primary palmar and axillary hyperidrosis through one-port access. Residual pain, postoperative complications, recurrence of symptoms, heart rate adjustment, and quality of life were analyzed. Multivariate analysis was performed.
  
  
  RESULTS
  No operative mortality and conversion to open surgery were recorded. Mean operative time was 38 ± 5 minutes. Mean hospital stay was 1.1 ± 0.6 days. Eight patients (6%) had unilateral pneumothorax. Twenty-five cases (19%) were complicated by compensatory sweating. Winter and fall were identified as protective factors for compensatory sweating occurrence. Decreased heart rate was observed 1 year after surgery and permanently over the time. No recurrence during the follow-up period (31.5 months) was observed and 90% of patients showed improved quality of life.
  
  
  CONCLUSIONS
  One-stage bilateral miniuniportal thoracoscopic sympathectomy is a valid and safe treatment for primary hyperhidrosis, achieving definitive and esthetic results, with excellent patients' satisfaction. Compensatory sweating may potentially occur in a season-dependent manner.
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Division of Thoracic Surgery, "G. Mazzini" Hospital of Teramo, Faculty of Medicine and Surgery, University of L'Aquila, Piazza Italia 1, 64100 Teramo, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Menna
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Andreetti
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ciccone
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Andrilli
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maurizi
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Leda Marina
authors.initials: LM
authors.lastname: Pomes
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cassiano
authors.affiliation: Division of Thoracic Surgery, Policlinico Umberto I Hospital, Faculty of Medicine and Pharmacy, University of Rome "Sapienza", Viale del Policlinico 155, 00186 Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Venuta
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, Faculty of Medicine and Psychology, University of Rome "Sapienza", Via di Grottarossa 1035, 00189 Rome, Italy ; Fondazione Eleonora Lorillard Spencer Cenci, Via Di Casal de' Pazzi 10, 00156 Rome, Italy.
authors.forename: Erino A
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053401:Palmar Plate / Q000601:surgery; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome