Bilateral endoscopic thoracic sympathectomy via single incision for the treatment of palmar and axillar hyperhidrosis
Keywords:Hyperhidrosis, Quality of life, Uniportal thoracoscopic surgery, Sympathectomy
Aim: Video-assisted thoracoscopic sympathectomy (VATS) is a safe, minimally invasive and effective procedure for primer hyperhidrosis. In this research, we aimed to present the advantages of uniportal endoscopic thoracic sympathectomy (ETS) surgery on patients who had palmar and axillary hyperhidrosis and did not respond to medical treatment.
Methods: Between February 2012 and November 2018, 46 ETS surgeries were performed on 23 patients (12 female patients and 11 male patients; the average age was 21 [16-27]) and the outcomes were evaluated in this retrospective cohort study. Uniport (Richard Wolf) sympathicotripsy and Kuntz nerve ablation were performed. We presented all the data about surgical techniques, perioperative-postoperative complications and patient satisfaction with their long-term results.
Results: During the long term follow-ups of our patients, compensatory hyperhidrosis was the most frequently observed finding. Hyperhidrosis occurred in multiple areas of the body in 11 of the patients (47%). 22 patients were completely satisfied with ETS surgery, and one of our patient with compensatory back sweats reported partial satisfaction. Recurrent hyperhidrosis was observed on the left side of one of our patients at 33 months post-operative examination. Minimal pneumothorax was observed in one of the patients, and it was regressed with medical treatment. The average operation duration was recorded as 21 minutes (15-31) per each hemithorax.
Conclusion: In conclusion, endoscopic thoracic sympathectomy is a treatment option with low mortality and morbidity. This approach should be considered for patients with palmar and axillar hyperhidrosis that medical treatment was not effective.
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