The effect of upper dorsal thoracoscopic sympathectomy on the total amountof body perspiration

Thoracoscopic T-2-T-3 sympathectomy is the treatment of choice for primary palmar hyperhidrosis (PPH); however, compensatory hyperhidrosis (CH) is a d isturbing sequela of this operation, the mechanism of which is poorly under stood. This study was conducted to evaluate the effect of heat stress on to tal body perspiration after thoracoscopic T-2-T-3 sympathectomy, and determ ine its correlation with CH. A total of 17 patients with PPH who underwent bilateral T-2-T-3 sympathectomy were subjected to heat stress induced by a 10-min sauna bath (ambient temperature 70 degreesC), 1 day before and 1 mon th after surgery. The naked body weight was recorded before and immediately following the sauna bath, and the patients were followed up to assess whet her CH had developed and the degree of its severity. Postoperatively, the a mount of perspiration increased in 13 patients and decreased in 1. The amou nt of perspiration induced by the sauna bath ranged from 60 to 480g, with a mean value of 185.29 +/- 125.80g, before the operation, and from 60 to 540 g, with a mean value of 265.88 +/- 154.05g, after the operation (P = 0.0113 ). There was no correlation between the degree of alteration in total body perspiration and the development of CH. Performing thoracoscopic T-2-T-3 sy mpathectomy for PPH affects the total body sweating response to heat; howev er, the development of CH does not correlate with this alteration.