Our Experience on Single-Port Bilateral Endoscopic Thoracal Sympathectomy for the Treatment of Palmar and Axillary Hyperhidrosis

Objective: In this study, we aimed to present our experience on endoscopic thoracic sympathectomy for palmar and axillary hyperhidrosis that does not respond to medical treatment and affects the social lives of people.

Methods: We retrospectively reviewed the data of 20 patients (11 men and 9 women) with a mean age of 25.4 (17–34) years who underwent 40 bilateral endoscopic sympathectomy operations in the same session in our clinic between April 2013 and July 2014. In 12 (60%) patients at the level of T2-T3 and in 8 (40%) patients at the level of T3-T4; the sympathetic ganglions and the Kuntz nerve were ablated by using a single port approach. Postoperative chest X-ray was performed to all patients. All data regarding surgical technique, duration of operation, perioperative and postoperative complications, patient satisfaction, and long-term outcomes were presented.

Results: In long-term follow-up, 12 (60%) patients developed compensatory hyperhidrosis in various body regions. There was no recurrence in any case. Eighteen patients were satisfied and two were partially satisfied with the results of endoscopic thoracic sympathectomy. One patient developed pneumothorax that required intervention, and there was expansion failure in two patients who did not require any intervention. The mean duration of operation was 34.2 (25–45) minutes. There was no surgical mortality. The mean duration of follow-up was 12.4 (5–22) months.

Conclusion: We conclude that endoscopic thoracic sympathectomy is a preferable method with a low mortality and morbidity and high satisfaction in the long-term, despite the risk of late onset compensatory perspiration in elective patients with palmar and axillary hyperhidrosis.