Endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: Intermediate term results

Background: The authors' experience of the efficacy and safety of endoscopi c thoracic sympathectomy in the treatment of primary palmer hyperhidrosis w as examined. Methods: A retrospective study of 71 patients ( 126 sympathectomies) was un dertaken. Data were retrieved by hospital records and telephone interview. Results: Follow-up was possible far 92 sympathectomies in 53 patients. Over all, satisfactory results were achieved in 93% of patients and complication s were uncommon. Compensatory hyperhidrosis was the most common complicatio n, which occurred in 64% of patients; the trunk and feet were the most comm on sites. Homer's syndrome occurred in five patients, although in two it wa s a permanent complication. No patient expressed dissatisfaction with the p rocedure as a consequence of this complication. Pneumothorax occurred in 17 .5% of cases, although the vast majority were incidental findings on a post operative chest X-ray, and none required drainage. With the newer technique s of access, patient dissatisfaction with the cosmetic appearance has falle n from 27.3 to 6.4%. Overall 90% of patients said they would have the opera tion again, which represents a high level of patient satisfaction Conclusions: Endoscopic thoracic sympathectomy is a safe and effective tech nique for primary palmer hyperhidrosis. Evolution of the technique has resu lted in improvement in patient satisfaction.