Single-center experience of thoracoscopic sympathectomy for palmar hyperhidrosis with long-term postoperative questionnaire survey

Megumi Kobayashi; Yosuke Kumaya; Yasumiko Hirayama; Hiromi Oda; Hiroyuki Cho; Cheng-Long Huang

doi:10.1007/s11748-024-02034-w

Single-center experience of thoracoscopic sympathectomy for palmar hyperhidrosis with long-term postoperative questionnaire survey

Gen Thorac Cardiovasc Surg. 2024 Apr 27. doi: 10.1007/s11748-024-02034-w. Online ahead of print.

Authors

Megumi Kobayashi¹, Yosuke Kumaya², Yasumiko Hirayama², Hiromi Oda², Hiroyuki Cho², Cheng-Long Huang²

Affiliations

¹ Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan. me_kobayashi@kuhp.kyoto-u.ac.jp.
² Department of Thoracic Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan.

PMID: 38676901
DOI: 10.1007/s11748-024-02034-w

Abstract

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.

Keywords: Compensatory hyperhidrosis; Palmar hyperhidrosis; Quality of life; Thoracoscopic sympathectomy (TS).