Long-term results of 45 thoracoscopic sympathicotomies for primary hyperhidrosis in children

Background/Purpose: Thoracoscopic sympathicotomy (TS) is successful in trea tment of excessive hyperhidrosis of the upper limb after limited follow-up observation. The aim of the study was to assess for the first time long-ter m results of TS in children. Methods: A total of 26 children (9 boys, 17 girls) aged 11 to 17 years with severe palmer or axillar hyperhidrosis underwent TS, and 19 patients were treated bilaterally. A total of 19 patients were observed after a median fo llow-up period of 16 years by questionnaire or clinical examination. Results: Permanent relief from palmar hyperhidrosis was given in all examin ed patients. Twelve patients had compensatory and 12 patients gustatory swe ating. Postoperatively, 1 subcutaneous emphysema and 1 temporary miosis and ptosis were noted. Eleven patients were fully satisfied with the result. S even patients were only partially satisfied because of compensatory or gust atory sweating but would again undergo operation. One patient was not satis fied because of excessive compensatory sweating. Conclusions: TS is a safe and efficient procedure even after long-term foll ow-up. Severe palmar hyperhidrosis often starts in childhood; thus, early s urgical treatment can improve social development. Compensatory and gustator y sweating are the most frequent and enduring side effects and should be me ntioned in preoperative patient and parent information. J Pediatr Surg 34:1 839-1842. Copyright (C) 1999 by W.B. Saunders Company.