Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis: four-year outcome and quality of life after bilateral 5-mm dual port approach

Abstract

Currently different effective surgical approaches for the treatment of hyperhidrosis with improvement rates of more than 80% are available. The quality of the intervention has to be evaluated by changes in quality of life and intensity of compensatory sweating. Thoracoscopic sympathectomy as performed in our institution offers results and complications comparable to previously published trials; however, because of single-lumen ventilation the management is much easier. Therefore, this technique offers an interesting option for the treatment of patients with palmar and axillary hyperhidrosis.

An alternative to treat palmar hyperhidrosis: use of oxybutynin

“…The prognostic factors currently associated with worsening of QOL following thoracic sympathectomy to treat hyperhidrosis are surgical failure and severe compensatory hyperhidrosis [23,24]. In contrast, with clinical treatment, we did not observe any worsening of QOL.…”

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis

“…One of most troublesome side effects of thoracic sympathectomy is compensatory sweating, which interferes with the patient's quality of life and causes patient dissatisfaction [9][10][11]. Chang et al demonstrated that the degree of patient satisfaction is significantly inversely related to the severity of compensatory sweating after sympathectomy, which supports our results [12].…”

The use of oxybutynin for treating facial hyperhidrosis

“…The prognostic factors currently associated with worsening of QOL following thoracic sympathectomy to treat hyperhidrosis are surgical failure and severe compensatory hyperhidrosis. 26,27 On the other hand, with clinical treatment, we did not observe any worsening of QOL. In the worst cases, QOL remained unchanged.…”