The aim of the study: The goal of this retrospective study was to evaluate the outcomes of bilateral thoracoscopic sympathectomy for primary hyperhidrosis. Methods: We identified all patients who underwent bilateral thoracoscopic sympathectomy between January 2017 and May 2020, in Sana’a (capital of YEMEN) hospitals. Details of pre-operative symptoms, surgical procedure and post-operative complications were collected from the patient’s files, and each patient was sent a questionnaire regarding success of the procedure, and compensatory sweating through their phone number by what Sapp. Results: We had 36 patients complaining of hyperhidrosis: 27 cases were males and 9 cases were females, age range 14 - 32 years at the time of surgery. All of them suffered from hyperhidrosis in the palm and sole, 15 cases of them suffered from hyperhidrosis in axilla, and 10 cases of patients were associated with facial blushing. All cases improved from sweat in the palm (100%), and most of them improved from the sweat of sole (94.6%). Conclusion: Thoracoscopic sympathectomy is effective in the treatment of hyperhidrosis. However, compensatory hyperhidrosis seems unavoidable complication and infrequently improves with time, so patients should be clearly informed before committing to surgery.
Cite this paper
Obadiel, Y. A. , Megally, A. M. , Alqatta, M. A. , Almorish, T. , Megally, Z. A. and Mujlli, H. (2020). Thoracoscopic Sympathectomy for Hyperhidrosis. Open Access Library Journal, 7, e6864. doi: http://dx.doi.org/10.4236/oalib.1106864.
Sammons, J.E. and Khachemoune, A. (2017) Axillary Hyperhidrosis: A Focused Review. Journal of Dermatological Treatment, 28, 582-590.
https://doi.org/10.1080/09546634.2017.1309347
Vannucci, F. and Araújo, J.A. (2017) Thoracic Sympathectomy for Hyperhidrosis: From Surgical Indications to Clinical Results. Journal of Thoracic Surgery, 9, S178-S192. https://doi.org/10.21037/jtd.2017.04.04
Currie, A.C., Evans, J.R. and Thomas, P.R.S. (2011) An Analysis of the Natural Course of Compensatory Sweating Following Thoracoscopic Sympathectomy. International Journal of Thoracic Surgery, 9, 437-439.
https://doi.org/10.1016/j.ijsu.2011.04.006
Dumont, P., et al. (2004) Long-Term Results of Thoracoscopic Sympathectomy for Hyperhidrosis. Annals of Thoracic Surgery, 78, 1801-1807.
https://doi.org/10.1016/j.athoracsur.2004.03.012
Prasad, A. (2008) Endoscopic Thoracic Sympathectomy for Hyperhidrosis: Technique and Results. Journal of Minimal Access Surgery, 4, 23.
https://doi.org/10.4103/0972-9941.40995
Öncel, M., Sunam, G.S., Erdem, E., Dereli, Y., Tezcan, B. and Akyol, K.G. (2013) Bilateral Thoracoscopic Sympathectomy for Primary Hyperhydrosis. Cardiovascular Journal of Africa, 24, 137-140. https://doi.org/10.5830/CVJA-2013-007
Lin, T.S., Wang, N.P. and Huang, L.C. (2001) Pitfalls and Complication Avoidance Associated with Transthoracic Endoscopic Sympathectomy for Primary Hyperhidrosis (Analysis of 2200 Cases). International Journal of Surgical Investigation, 2, 377-385.
Doolabh, N., Horswell, S., Williams, M., et al. (2004) Thoracoscopic Sympathectomy for Hyperhidrosis: Indications and Results. The Annals of Thoracic Surgery, 77, 410-414. https://doi.org/10.1016/j.athoracsur.2003.06.003
Deng, B., Tan, Q.-Y., Jiang, Y.-G., Zhao, Y.-P., Zhou, J.-H., Ma, Z. and Wang, R.-W. (2010) Optimization of Sympathectomy to Treat Palmar Hyperhidrosis: The Systematic Review and Meta-Analysis of Studies Published during the Past Decade. Surgical Endoscopy, 25, 1893-1901. https://doi.org/10.1007/s00464-010-1482-3
Hashmonai, M., Cameron, A.E.P., Licht, P.B., Hensman, C. and Schick, C.H. (2016) Thoracic Sympathectomy: A Review of Current Indications. Surgical Endoscopy, 30, 1255-1269. https://doi.org/10.1007/s00464-015-4353-0
Rodríguez, P.M., Freixinet, J.L., Hussein, M., Valencia, J.M., Gil, R.M., Herrero, J. and Caballero-Hidalgo, A. (2008) Side Effects, Complications and Outcome of Thoracoscopic Sympathectomy for Palmar and Axillary Hyperhidrosis in 406 Patients. European Journal of Cardio-Thoracic Surgery, 34, 514-519.
https://doi.org/10.1016/j.ejcts.2008.05.036
Licht, P.B. and Pilegaard, H.K. (2004) Severity of Compensatory Sweating after Thoracoscopic Sympathectomy. The Annals of Thoracic Surgery, 78, 427-431.
https://doi.org/10.1016/j.athoracsur.2004.02.087
Riet, M., Smet, A.A.E.A., Kuiken, H., Kazemier, G. and Bonjer, H.J. (2001) Prevention of Compensatory Hyperhidrosis after Thoracoscopic Sympathectomy for Hyperhidrosis. Surgical Endoscopy, 15, 1159-1162.
https://doi.org/10.1007/s004640090097