Thoracic sympathectomy under Video-Mediastinoscopy and Video-assisted thoracoscopy for palmar hyperhidrosis

Objective: To explore the feasibility of thoracic sympathectomy under Video-Mediastinoscopy (VM) for palmar hyperhidrosis. Method: Under general anesthesia with endotracheal tubeplacement .The patients were maintained in the 30°～45° semi-sitting position , with abduction of both arms to 90°. The VM entered the thoracic cavity via the third intercostals space on the anterior axillary line .The T2～T4 sympathetic ganglions were resected by electrocautery . Result:Hyperhidrosis disappeared post operatively in all the cases. The temperature of patients ’ both hands increased by 1.5～3.0℃ .The operation time was 20～40min (mean,30min) and the hospital stay was 3～30d(mean, 3.54d). No severe complications occurred. Conclusion:Thoracic sympathectomy under VM is less invasive and simple than that under video-assisted thoracoscopic surgery (VATS) in the treatment of Palmar hyperhidrosis,being a feasible alternative.