Transection of More Than One Sympathetic Chain Ganglion for Hyperhidrosis Increases the Severity of Compensatory Hyperhidrosis and Decreases Patient Satisfaction

Endoscopic Transthoracic Limited Sympathotomy for Palmar-Plantar Hyperhidrosis: Outcomes and Complications During a 10-Year Period

“…However, recent series strongly suggest what we have practiced for more than a decade: simple T2 sympathectomy yields excellent results for the hands and lessens the chances of severe postoperative compensatory hyperhidrosis, and the more aggressive resections of the sympathetic chain increase the risk of severe postoperative compensatory hyperhidrosis. [10][11][12][13][14][15][16] The extremely disagreeable complication of severe compensatory hyperhidrosis (in which the patient regrets the operation because of resultant profound increased new sweating elsewhere) remains the most problematic because no satisfactory treatment is available if it occurs.…”

Thoracoscopic excision of the sympathetic chain: an easy and effective treatment for hyperhidrosis in children

“…Different authors described the technique for TS in various ways including diathermy ablation [1], chemical ablation [2], ultrasonic coagulation [3] and transection of the sympathetic chain [4] with varying degrees of success. It appears that more aggressive approaches are associated with better results.…”

“…Conservative measures are usually ineffective in severe cases. Thoracoscopic sympathectomy (TS) as an effective treatment for upper limb hyperhidrosis has been described in different ways including; diathermy ablation [1], chemical ablation [2], ultrasonic coagulation [3] and transection of the sympathetic chain [4] with varying degrees of success. Most large series involve adolescents or adult population [5,6] with less reported experience in children below 13 years of age.…”

Up-to-date Treatments of Primary Hyperhidrosis with Focus on Sympathectomy and Sympathicotomy; A Narrative Review

“…According to the majority of studies, performing surgery on fewer ganglia does not decrease CS, but operating on a single ganglion does. Some studies, however, have reported no reduction in CS in surgeries on even a single ganglion [40][41][42]. A very low prevalence of post-operative CS (7.2%) is reported in a case series of selective postganglionic thoracic sympathicotomy (or ramicotomy) performed via robotic VATS surgery.…”