3-year follow-up after uniportal thoracoscopic sympathicotomy for hyperhidrosis: undesirable side effects.
OBJECTIVE
Endoscopic thoracic sympathectomy or sympathicotomy, for the treatment of palmar, axillary, and plantar hyperhidrosis, is generally performed at one or two levels, between T2 and T5. Compensatory sweating (CS) is a severe and undesirable side effect of this procedure. Here, we describe the success of treatment and degree of postoperative CS in sympathicotomy patients.


METHODS
This study included 80 patients treated by uniportal (5-mm) thoracoscopic sympathicotomy (electrocautery) for primary hyperhidrosis over a 6-year period (2007-2013). Sympathicotomy was performed bilaterally at T2 for blushing (n=2), T2-T3 for palmar-only hyperhidrosis (n=34), T2-T4 for palmar and axillary hyperhidrosis (n=39), and T3-T4 for axillary-only hyperhidrosis (n=5). Outcome was assessed 2 weeks postsurgery at the clinic and annually thereafter by telephone questionnaire. Mean follow-up time was 35.2±23.3 months. Questionnaires assessed patients' degree of sweating, postoperative CS, overall satisfaction, and complications.


RESULTS
Seventy-one patients (88.7%) were very satisfied, whereas only 9 (11.3%) were dissatisfied with the procedure. Complication incidence was 7.5%, and CS occurred in 77.5% of patients. Therapeutic success rate was 97.5%; complete relief of hyperhidrosis was achieved in 72 (90%) patients, whereas 8 (10%) experienced recurrence.


CONCLUSIONS
CS is a frequent side effect of thoracoscopic sympathicotomy. We recommend all patients undergoing this procedure should be warned of the potential risk of developing severe CS.
1 Department of Thoracic Surgery, Trakya University Faculty of Medicine , Edirne, Turkey .
Yekta Altemur
YA
Karamustafaoglu
Mustafa
M
Kuzucuoglu
Fazlı
F
Yanik
Gonul
G
Sagiroglu
Yener
Y
Yoruk
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D007049:Iatrogenic Disease; D008297:Male; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D013546:Sweating; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult