The Results of a Long-Term Follow-up of Bilateral Single Port Sympathicotomy in Primary Hyperhidrosis: Should We Perform This Surgery?

Abstract

Background: Hyperhidrosis (HH), which refers to excessive sweating of the body in response to temperature or emotional stimuli rather than physiological stimuli, can adversely affect quality of life. In this prospective study, we investigated the long-term effects, development of complications, and patient satisfaction among those who underwent bilateral single-port endoscopic thoracic sympathecotomy (ETS) for HH. Methods: Thirty-one patients who underwent bilateral single-port endoscopic thoracic sympathicotomy (ETS) for HH between January 200 and November 2014 were enrolled in this study. The patients wer1e followed up until July 2017. Patient satisfaction in terms of the primary complaint (PC) and complications, such as compensatory hyperhidrosis (CH), in the short and long term were recorded. Results: The mean follow-up period was 60.6 ± 12.8 (min: 40, max: 89) mo postoperatively. When both the short-and long-term results were evaluated together, CH had no effect on patient satisfaction. However, persistence of the PC in both the short (p = 0.020) and long term (p = 0.001) had a significant effect on satisfaction. Conclusion: The most important factor affecting patient satisfaction was PC persistence. Thus, further studies should be performed to enlighten this complication. even though it may remit with time. Whether ETS is a permanent treatment that cannot successfully treat PC, possible complications and the ability to cope with them will seem to be open to debate as the most important issues that surgeons will have to face in the near future.

Clinical Outcomes of Uniportal Versus Multiportal Endoscopic Thoracic Sympathectomy in Patients With Severe Palmar and Axillary Hyperhidrosis

“…Secondary hyperhidrosis is the result of other causes such as malignancy, endocrine disorders or the side effects of some drugs or medications, whereas in primary hyperhidrosis, the nerves responsible for signaling the sweat glands become overactive [1,3]. Common treatments include the use of skin creams, systemic anticholinergic drugs, topical injection of botulinum toxin A, and even surgical procedures [1, 3,4]. Surgical procedures include local removal of axillary sweat glands as well as thoracoscopic blocking of certain branches of the thoracic sympathetic chain [5].…”

“…As a result of its minimally invasive character, it has become the preferred surgical procedure in the recent years. In such cases, due to the satisfactory early outcomes, namely short hospital stays and low complications, the procedure is highly tolerable [3].…”