title: [Effect of T4 thoracoscopic sympathectomy on  plantar hyperhidrosis in patients with  primary palmoplantar hyperhidrosis].
abstract: OBJECTIVE
  To evaluate the effect of video-assisted thoracoscopic sympathectomy at the T4 level on plantar hyperhidrosis in the treatment of palmoplantar hyperhidrosis.
  
  
  METHODS
  The clinical data of 28 patients with primary palmoplantar hyperhidrosis, who were admited in our hospital from June 2009 to May 2014, was analyzed. All patients were qualified to bilateral thoracoscopic transaction of the sympathetic chain at the thoracic level T4. Patients completed a self-administered hyperhidrosis questionnaire and scoring before and after procedure. Follow-up data were obtained at 1 and 6 months after the surgery.
  
  
  RESULTS
  Endoscopic thoracic sympathectomy at the thoracic level T4 was performed successfully for all cases. Palmar hyperhidrosis was completely alleviated after the operation and no recurrence was observed during follow-up. The ratio for initial improvement of plantar hyperhidrosis was 28.6% (8/28) at 1 month after the surgery followed by a recurrence of plantar hyperhidrosis. No case continued to show the improvement of palmoplantar hyperhidrosis at 6 months after the sympathectomy. Twenty-seven patients (96.4%) were very satisfied with the outcome of the operation, 1 patient (3.6%) satisfied and no patient regretted the surgical procedure.
  
  
  CONCLUSIONS
  T4 thoracoscopic sympathectomy could initialliy alleviate plantar hyperhidrosis in some patients with palmoplantar hyperhidrosis, but the improvement was not sustained over a long period. It could not be used to treat plantar hyperhidrosis.
authors.affiliation: Department of Thoracic Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Xiao
authors.affiliation: Department of Epidemiology, School of Public Health, Central South University, Changsha 410078, China.
authors.forename: Aizhong
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
authors.forename: Wenliang
authors.initials: W
authors.lastname: Liu
mesh_terms: D005528:Foot; D006801:Humans; D006945:Hyperhidrosis; D012008:Recurrence; D011795:Surveys and Questionnaires; D013562:Sympathectomy; D013564:Sympathetic Nervous System; D020775:Thoracic Surgery, Video-Assisted