Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Immediate Results and Postoperative Quality of Life

Diagnosis and Treatment of Primary Hyperhidrosis

“…Numerous studies indicate that the treatment of primary hyperhidrosis with thoracic sympathectomy is a safe and effective method (4,20,28,49,51,(57)(58)(59)(60)(61)(62)(63). Treatment results depend on the centre which performs the procedure, but the percentage of complete symptoms relief remains usually at 95% (51,(57)(58)(59)(60)(61)(62)(63).…”

“…Treatment results depend on the centre which performs the procedure, but the percentage of complete symptoms relief remains usually at 95% (51,(57)(58)(59)(60)(61)(62)(63). The most serious intraoperative problems include: the presence of pleural adhesions (incidence <3%), hindered visualization of gangliated cord due to excessive adipose tissue (ca.…”

“…The most common complication is postoperative pain that occurs in 30-90% of patients (51,(57)(58)(59)(60)(61)(62)(63). Other early complications such as pneumothorax with required drainage, neurological disorders of upper limbs are encountered rarely, with a frequency not exceeding 5% (51,(57)(58)(59)(60)(61)(62)(63)). Horner's syndrome, significant bleeding, subcutaneous oedema, chylothorax, rupture of subclavian artery, intracostal neuralgia are encountered even less frequently, below 1% of patients subjected to thoracic sympathectomy (4, 20, 28,4 9, 51, 57-63).…”

“…Bleedings and postsurgical pain may be minimized by careful introduction of trocars, use of 5 mm optics and trocar, injecting point of entry port of local anaesthetics, such as bupivacaine. Incidence of pneumothorax is minimized by avoiding to damage lung parenchyma during the initial placement of the port (57)(58)(59)(60)(61)(62)(63).…”

“…All those factors significantly influence life quality impairing it in all dimensions of this generic construct. The strongest impairment is observed in emotional and functional component, then social (60,67).…”