ENDOSCOPIC TRANSTHORACIC SYMPATHECTOMY - AN EFFICIENT AND SAFE METHODFOR THE TREATMENT OF HYPERHIDROSIS

Background: Hyperhidrosis of the palms, axillae, and face has a strong negative impact on the quality of life for many persons. Existing non surgical therapeutic options are far from ideal. Definitive cure can b e obtained by upper thoracic sympathectomy. The traditional open surgi cal technique is a major procedure; few patients and doctors have foun d that risk-benefit considerations favor surgery. Endoscopic minimal i nvasive surgical techniques are now available. Objective: We investiga ted whether endoscopic ablation of the upper thoracic sympathetic chai n is efficient and safe in the treatment of hyperhidrosis. Methods: We treated 850 patients with bilateral endoscopic transthoracic sympathe ctomy. Results: There was no mortality or life-threatening complicatio n. Nine patients (1%) required intercostal drainage because of hemotho rax or pneumothorax. Treatment failure occurred in 18 cases (2%) and s ymptoms recurred in 17 patients (2%). At the end of follow-up (median, 31 months) 98% of the patients reported satisfactory results. Conclus ion: Endoscopic transthoracic sympathectomy is an efficient, safe, and minimally invasive surgical method for the treatment of palmar, axill ary, and facial hyperhidrosis.