Targeting the Sympathetic Chain for Primary Hyperhidrosis: An Evidence-Based Review.
Large case series and randomized trials over the past 25 years have consistently demonstrated thoracoscopic interruption of the sympathetic chain to be a safe and effective treatment of focal primary hyperhidrosis. The surgical technique has evolved toward less-invasive and less-extensive procedures in an effort to minimize perioperative morbidity and effectively balance postoperative compensatory sweating with symptomatic relief. This review summarizes available evidence regarding the surgical approach and the optimal level of interruption of the sympathetic chain based on a patient's presenting distribution of pathologic sweating.
Department of Surgery, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Suite 3-150, Chicago, IL 60611, USA.
Joel M
JM
Sternbach
Division of Thoracic Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 650, Chicago, IL 60611, USA. Electronic address: mdecamp@nm.org.
Malcolm M
MM
DeCamp
D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D057240:Patient Preference; D013562:Sympathectomy / Q000379:methods*; D013564:Sympathetic Nervous System / Q000033:anatomy & histology / Q000601:surgery; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome
Compensatory sweating; ETS; Endoscopic thoracic sympathectomy; Hyperhidrosis; Sympathetic surgery; Sympathicotomy; Sympathotomy