LONG-TERM RESULTS OF 630 THORACOSCOPIC SYMPATHICOTOMIES FOR PRIMARY HYPERHIDROSIS - THE VIENNA EXPERIENCE

Objective: To evaluate of the results of thoracoscopic sympathicotomy for upper limb hyperhidrosis with a median observation period of more than 15 years. Design: Retrospective clinical observation study. Setti ng: University-affiliated tertiary referral centre. Subjects: 630 cons ecutive operations in 352 patients (median age 30.1 yrs) for primary p almar (68%), axillary (12.7%) and combined hyperhidrosis (19.3%). Inte rventions: Thoracoscopic sympathicotomy from below T1 to T4 including the fibres of Kuntz using electrocautery through single site access. M ain outcome measures: Perioperative success and complication rates tal l patients); long-term follow-up by a questionnaire and/or clinical ex amination (83.3% of patients) after a median period of 16 yrs. Calcula tion of statistical significance of differences between groups with c2 -test. Results: 67.8% of patients were fully satisfied, 25.7% were par tially satisfied and would again agree to the operation. In 93% the pr ocedure cured hyperhidrosis permanently. Compensatory and gustatory sw eating was observed in 67% and 47% of cases, respectively. Overall suc cess was significantly (p < 0.001) lower in the group with axillary hy perhidrosis. Main complications: drainage for pneumothorax 1.3%, Horne r's syndrome in 3.8%, subcutaneous emphysema 2.1%. Conclusion: Thoraco scopic sympathicotomy proved to be highly effective even after long-te rm follow-up. Compensatory sweating impairs patients' satisfaction in some cases.