Observation on treatment of primary palmar hyperhidrosis by thoracoscopic sympathectomy

Objective To observe and compare the treatment of primary palmar hyperhidrosis by thoracoscopic sympathectomy at T2 and T3 level.Methods From March 2008 to April 2010,42 cases of palmar hyperhidrosis underwent thoracoscopic sympathectomy,in which 25 cases underwent sympathectomy in T2～4 segments and 17 cases in T3～4 segments.Out-patient and telephone follow-up were carried out after 1,6,12 and 24 months to observe the recurrence and postoperative compensatory hyperhidrosis of the patients.Results Symptoms of palmar hyperhidrosis disappeared immediately after surgery,without death and infection of incisional wound.All the patients were discharged 3 to 6 days after surgery,with the average length of stay for 4.1±0.8 days.During the postoperative follow-up,there was no Horner's syndrome and recurrence.No significant difference was observed in the incidence of compensatory hyperhidrosis in each observation period(P 0.05).There was no significant difference between the two groups in the severity of compensatory hyperhidrosis during follow-up 1 month after surgery.At the 6th and 12th month after surgery,compensatory hyperhidrosis after sympathectomy in T2 ~ 4 segments is significantly more serious than that after sympathectomy in T3 ~ 4 segments(P 0.05).Conclusion Thoracoscopic sympathectomy is a good treatment for palmar hyperhidrosis with no recurrence after surgery.Compensatory hyperhidrosis after sympathectomy in T2 segment is obviously more serious than that after sympathectomy in T3 segment.The difference is not significant(P 0.05).