title: Effect of lowering or restricting sympathectomy levels on compensatory sweating.
abstract: OBJECTIVE
  There is controversy on whether lowering or restricting the level of sympathectomy can reduce compensatory sweating (CS). This study compared the results from sympathectomies performed to treat severe palmar hyperhidrosis using two distinct levels of T2-4 and T3-4.
  
  
  METHODS
  One hundred and sixteen patients with primary palmar hyperhidrosis were randomly allocated to undergo either T2-4 sympathectomy treatment (T2-4 group) or T3-4 sympathectomy treatment (T3-4 group). Follow-up data were collected using a telephone questionnaire to assess efficacy, side effects, overall satisfaction, and factors affecting CS and the degree of satisfaction.
  
  
  RESULTS
  There were no significant differences with respect to either CS or severe CS between the two treatment groups at 1, 6, or 12 months of follow-up. The total scores of the quality-of-life questionnaires after surgery were remarkably decreased compared with those before surgery in the two groups. However, no significant differences in quality-of-life scores were found between the two groups before surgery, or at 1, 6, or 12 months of follow-up. Age was predictive of severe CS at 6 months of follow-up (P = 0.045). Severe CS was inversely associated with patient satisfaction at 1, 6, and 12 months of follow-up.
  
  
  CONCLUSIONS
  The issue of whether lowering or restricting the level of sympathectomy reduces CS is controversial and needs more supportive evidence. Age may be a predictive factor for severe CS at 6 and 12 months of follow-up. Severe CS is the only known factor that affects patient satisfaction, and family history may also be associated with patient satisfaction.
authors.affiliation: Department of Cardiothoracic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou, 510630, Guangdong, China.
authors.forename: Songwang
authors.initials: S
authors.lastname: Cai
authors.forename: Shaohong
authors.initials: S
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: An
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.forename: Yimin
authors.initials: Y
authors.lastname: Weng
authors.forename: Hongying
authors.initials: H
authors.lastname: Liao
authors.forename: Huiguo
authors.initials: H
authors.lastname: Chen
authors.forename: Libao
authors.initials: L
authors.lastname: Liu
authors.forename: Jinyuan
authors.initials: J
authors.lastname: He
authors.forename: Junhang
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D013546:Sweating / Q000502:physiology*; D013562:Sympathectomy / Q000009:adverse effects* / Q000379:methods*; D013906:Thoracoscopy; D016896:Treatment Outcome; D055815:Young Adult
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