Thoracoscopic Sympathicotomy for Treatment of Hyperhidrosis

Background: Approximately, 3% of the world’s population have hyperhidrosis, a situation in which excessive sweating occurs in response to the need to regulate body temperature. Endoscopic devices have been used for treatment of this disease through sympathicotomy. Objectives: The aim of this study was to assess the effectiveness and adverse effects of endoscopic sympathicotomy in treatment of hyperhidrosis. Patients and Methods: We enrolled 41 patients in the study. Ganglion disconnection was performed at T2 T3 level for patients with palmar hyperhidrosis and at T3 T4 level for patients with axillary hyperhidrosis. Patients were evaluated for successful response to surgical treatment, occurrence of reflex hyperhidrosis following surgery, and location of reflex hyperhidrosis at one week and at six months of surgery. Results: After surgical treatment, 75.6% of patients reported complete response to treatment while 82.9% reported reflex hyperhidrosis after surgery. The frequency for moderate and severe sweating was 8.8% and 26.5%, respectively. Conclusions: Sympathicotomy technique can be used in the treatment of primary hyperhidrosis in patients who did not respond to nonsurgical treatments; however, the incidence of reflex hyperhidrosis is of concern following surgical treatment.