Transareolar single-port endoscopic thoracic sympathectomy with a flexible endoscope for primary palmar hyperhidrosis: a prospective randomized controlled trial

Abstract

Background: Transareolar single-port endoscopic thoracic sympathectomy (ETS) with a flexible endoscope has rarely been reported. This study assessed the performance of this novel minimally invasive technique for primary palmar hyperhidrosis (PPH).Methods: From January 2019 to September 2019, 118 males with severe PPH requiring single-port and bilateral ETS were randomly allocated to undergo transareolar ETS using a flexible endoscope (group A, n=58) or transaxillary ETS using a 5 mm thoracoscope (group B, n=60).Results: Both groups had similar patient characteristics. All procedures were performed successfully, with no mortality or conversion to open surgery. All patients had dry and warm palms immediately after surgery.Compared with group B, group A had a significantly shorter median incision length [5.

Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version)

“…Except for the incisions mentioned above, [ 40 , 41 ] several reports proposed the transumbilical [ 42 ] and subxiphoid [ 43 ] approaches with the initial purpose of cosmetic benefits and reduction of postoperative pain. [ 44 ] These novel approaches are not recommended due to increased surgical risks and operational difficulty, which compromises surgical safety.…”