ENDOSCOPIC THORACIC SYMPATHECTOMY FOR PRIMARY HYPERHIDROSIS OF THE UPPER LIMBS - A CRITICAL ANALYSIS AND LONG-TERM RESULTS OF 480 OPERATIONS

Objective This evaluated the long-term outcome after endoscopic thorac ic sympathectomy (ETS) from below D1 to D4, using a single-site access technique for primary hyperhidrosis of the upper limbs. Summary Backg round Data Primary hyperhidrosis of the upper limbs is a distressing a nd often socially disabling condition. Endoscopic thoracic sympathecto my is considered the treatment of choice, causing minimal morbidity an d high initial success rates. However, data regarding long-term result s are scarce. Methods Two hundred seventy of 323 patients (83.7%), in whom 480 sympathectomies were performed, answered a questionnaire afte r a mean of 14.6 years postoperatively regarding the early postoperati ve result, side effects, and complications caused by the operation and long-term results with particular emphasis on patient satisfaction. R esults There was no postoperative mortality and no major complications requiring surgical reintervention. A majority of the patients (98.1%) were relieved, and 95.5% were satisfied initially. Permanent side eff ects included compensatory sweating in 67.4%, gustatory sweating in 50 .7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfie d, and a 26.7% partially satisfied. Compensatory and gustatory sweatin g were the most frequently stated reasons for dissatisfaction. Individ uals operated for axillary hyperhidrosis without palmar involvement we re significantly less satisfied (33.3% and 46.2%, respectively).