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Objectives: Thoracoscopic sympathectomy is an effective treatment for palmar hyperhidrosis. However, compensatory hyperhidrosis occurs frequently as a postoperative complication of the procedure. The goal of this study was to elucidate the clinical significance of thoracoscopic sympathectomy using our surgical procedure.
Methods: Consecutive 151 patients who underwent thoracoscopic sympathectomy for palmar hyperhidrosis were studied. In addition, to investigate patients' satisfaction and long-term quality of life, 111 patients were asked to complete a mailing questionnaire survey, and 84 responded (response rate of 75.7%).
Results: All of the 151 patients reported a reduction in palmar sweating during the immediate postoperative period. None of the patients had pneumothorax, hemothorax, Horner's syndrome, or worsening of bradycardia. Based on the questionnaire, the surgical success rate was 98.8%. None of the patients had a recurrence of palmar hyperhidrosis during the long-term postoperative period. However, compensatory hyperhidrosis was reported in 82 patients (97.6%). In total, 94.0% of patients had high levels of postoperative satisfaction.
Conclusions: Thoracoscopic sympathectomy is an effective surgical treatment for palmar hyperhidrosis. By contrast, the careful preoperative explanation of compensatory hyperhidrosis is considered to be very important.
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http://dx.doi.org/10.1007/s11748-024-02034-w | DOI Listing |
J Robot Surg
June 2025
Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University, No. 5, Fu-Hsing St. Kwei-Shan, Taoyuan, Taiwan.
Endoscopic thoracic sympathectomy (ETS) is widely used to treat primary hyperhidrosis; however, compensatory sweating (CS) has emerged as a significant complication. Various surgical approaches for managing CS have evolved over the past 4 decades, yet their development and outcomes remain poorly documented. This study aims to examine the historical evolution and advances in techniques for reconstruction of the thoracic sympathetic trunk.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
June 2025
Division of Pediatric Surgery, University of California San Francisco Benioff Children's Hospitals, Oakland and San Francisco, CA.
Background: Understanding the precise anatomy of the upper thoracic sympathetic trunk is crucial for effectively treating palmar hyperhidrosis using the surgical technique of endoscopic thoracic sympathectomy (ETS). The variability in the location of T2 and T3 ganglia in relation to the ribs may contribute to inconsistent clinical outcomes after ETS.
Methods: For the cadaver study, adult human cadaveric thoraces were dissected to map the locations of T2 and T3 ganglia by identifying their white rami communicantes.
J Thorac Dis
April 2025
Department of Anesthesiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Background: Compensatory hyperhidrosis (CH) is a frequent complication following sympathectomy, influencing patient satisfaction. This study was established to evaluate the impact of bilateral thoracoscopic sympathetic nerve block (TSNB) on patient satisfaction after sympathectomy in the treatment of primary hyperhidrosis.
Methods: From March 2021 to August 2023, 52 patients with primary palmar and craniofacial hyperhidrosis underwent TSNB at T3 using a 2-mm thoracoscope under local anesthesia.
Front Med (Lausanne)
April 2025
Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Primary palmar hyperhidrosis (PPH) is a somatic condition characterized by excessive sweating of the hands. It mainly affects adolescents and young adults and is rarely observed among children. This condition significantly impairs patients' academic performance, daily activities, and social interactions and can even lead to insurmountable psychological burdens.
View Article and Find Full Text PDFJ Cardiol Cases
March 2025
Department of Cardiovascular Medicine, Kyorin University School of Medicine, Mitaka, Japan.
Unlabelled: Recent research has demonstrated the effectiveness of cardiac sympathetic denervation in treating ventricular arrhythmias. We present a patient with dilated cardiomyopathy characterized by ventricular tachycardia (VT) resistant to standard treatments. Repeated left-sided stellate ganglion blocks provided temporary relief, followed by a thoracoscopic sympathectomy with T2-4 ganglionectomy, which significantly reduced the burden of VT.
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