Video-assisted Endoscopic Transthoracic Sympathectomy in Treatment of Palmar Hyperhidrosis(a Report of 22 Cases)

Objective To investigate the feasibility of video-assisted thoracic surgery technique in treatment of palmar hyperhidrosis.Methods 22 patients with palmar hyperhidrosis underwent partial Video-assisted endoscopic transthoracic sympathectomy(ETS) during June 2009 and June 2010.Double cavity tracheal cannula was used in the patients after general anaesthesia,and all the patients sat at 30～45° with upper arms stretching at 90°.After ventilation on the operated lung stopped,the two-sided surgery was performed at the same posture by exposing mediastinum superius and sympathectomy with falcate electric scalpel through a 2-hole EST pathway.Results After surgery,both hands in 22 patients were arid and florid,and no severe complications occurred.Compensatory torso hyperhidrosis occurred occasionally.After a 2 to 5-month follow-up,no relapse was reported. Conclusion Partial Video-assisted ETS can expose the chest sympathetic chain and locate the exact position.It is safe,less invasive,and helpful in early recovery with prolonged effect.