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Zacherl, J. et al.

Zacherl, Huber, Imhof, Plas, Herbst, Függer,

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. SETTING: University-affiliated tertiary referral centre. SUBJECTS: 630 consecutive operations in 352 patients (median age 30.1 yrs) for primary palmar (68%), axillary (12.7%) and combined hyperhidrosis (19.3%). INTERVENTIONS: Thoracoscopic sympathicotomy from below T1 to T4 including the fibres of Kuntz using electrocautery through single site access. MAIN OUTCOME MEASURES: Perioperative success and complication rates (all patients); long-term follow-up by a questionnaire and/or clinical examination (83.3% of patients) after a median period of 16 yrs. Calculation of statistical significance of differences between groups with c2-test. RESULTS: 67.8% of patients were fully satisfied, 25.7% were partially satisfied and would again agree to the operation. In 93% the procedure cured hyperhidrosis permanently. Compensatory and gustatory sweating was observed in 67% and 47% of cases, respectively. Overall success was significantly (p < 0.001) lower in the group with axillary hyperhidrosis. Main complications: drainage for pneumothorax 1.3%, Horner's syndrome in 3.8%, subcutaneous emphysema 2.1%. CONCLUSION: Thoracoscopic sympathicotomy proved to be highly effective even after long-term follow-up. Compensatory sweating impairs patients' satisfaction in some cases.[1]

References

Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Zacherl, J., Huber, E.R., Imhof, M., Plas, E.G., Herbst, F., Függer, R. The European journal of surgery. Supplement. : = Acta chirurgica. Supplement. (1998) [Pubmed]

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