Thoracoscopic sympathotomy for palmar hyperhidrosis: How young is too young?

Thoracoscopic sympathicotomy in children for the treatment of palmar and axillary primary focal hyperhidrosis: Caution advocated

“…Our high recurrence and reoperation rates following thoracoscopic sympathicotomy in children up to and including 16 years of age are not consistent with relatively recently published research, including the above-mentioned publication by Vasconcelos-Castro et al, which showed good results with no recurrence of PFH and low rates of compensatory sweating during follow-up advocating early surgical treatment in children with PFH [1,7]. However, these studies included 'children' with ages up to 19 and 21 years, respectively.…”

“…We read with great interest the article by Vasconcelos-Castro et al reporting the outcome of 23 patients undergoing thoracoscopic sympathotomy for primary palmar hyperhidrosis (PFH) [1]. They stated that bilateral two-port thoracoscopic sympathotomy is a safe and effective treatment for PFH in patients aged 11-19 years old.…”

Thoracoscopic sympathicotomy for the treatment of intolerable palmar and axillary hyperhidrosis in children is associated with high recurrence rates

“…Thoracoscopic sympathicotomy plays an indispensable role in the treatment of palmar and axillary PFH 11‐13 . However, the evidence concerning results and efficacy of thoracoscopic sympathicotomy in children up to 16 years of age is scarce if not absent 15‐17 …”

“…The high recurrence and reoperation rates following thoracoscopic sympathicotomy in children up to 16 years of age, as found in our study, are not consistent with the previous research. Three previous studies concerning thoracoscopic sympathicotomy in children showed good results with no recurrence of PFH and low rates of CH during follow‐up advocating early surgical treatment in children with PFH 15,17,21 . However, these studies included “children” with ages up to 17, 19, and 21 years, respectively.…”

“…However, little is known about the results and prognosis of thoracoscopic sympathicotomy in children, especially as PFH often reveals itself during childhood 15‐17 . Recently, a retrospective analysis of bilateral thoracoscopic sympathicotomy in “children” aged 11 to 19 years showed good results with no recurrence of PFH during follow‐up and advocated bilateral thoracoscopic sympathicotomy as a safe and effective treatment for palmar PFH in children 17 . Because the impact of PFH on the developing life of minors may even be greater and neuroregeneration by Schwann cell plasticity is especially seen in young children, we used an age limit of 16 years 18,19 .…”