Video-assisted thoracoscopic sympathicotomy for the treatment of pahnar hyperhidrosis in 588 cases

Objective To evaluate the efficacy of video-assisted thoracoscopie sympathicotomy in the treatment of palmar hyperhidrosis and introduce the clinical experience in the prevention of complications.Methods The clinic data of 588 cases of palmar hyperhidrosis who underwent bilateral sympathicotomy from January 2003 and March 2007 was analyzed retrospectively.The curative results were compared between the T_2 levels denervation group(group A)and the T_2 levels remained denervation group (group B).Results All operations were successfully performed under thoraeoscope without severe morbidity and mortality.The curative rate of palmar hyperhidrosis was 99.8%.Accompanied axiilary sweating and plantar sweating were improved in 84.0% and 71.0% patients respectively.All the patients were evaluated by a follow-up for 1 to 48 months with an average time of(20.3±2.3)months on the aspects of curative effect and occurrence of compensatory sweating.During one week after surgery,the transient postoperative hand sweating recurred in 10 cases and then disappeared within 1 to 3 days.Two cases experienced gustatory hyperhidrosis.One case experienced hand sweating at 8 th month postoperative.Side- effect of compensatory sweating were observed in 28.0 percents of group A and 13.4 percents of group B(P 0.01).Conclusions Video-assisted thoracoscopic sympathicotomy is an effective,safe and minimally invasive method for the treatment of hyperhidrosis.The method of T_2 levels remained denervation appears associated with less comDensatorv sweating.