Bilateral sympathectomy via thoracoscope for treatment of idiopathic hyperhidrosis

Objective To summarize our experience in endoscopic thoracic sympathectomy (ETS) in treating palmar hyperhidrosis (PH) and investigate the feasibility of ETS for treating PH by hand surgeons.Methods From 2006 to 2010,23 patients who had palmar hyperhidrosis were treated by a single surgeon via endoscopic thoracic sympathectomy.The T2 to T3 thoracic sympathetic chain was interrupted by electrocautery.The patients were followed up once every three months.Treatment that resulted in palm skin temperature increase of 1℃ or more and dry and warm palm skin was considered effective.Treatment that resulted in palm skin temperature increase less then 1℃ and wet palm skin was considered ineffective.Results All patients had immediate cessation of palmar hyperhidrosis.Mild compensatory hyperhidrosis on the back or sole was noted in 4 patients.No moderate to severe compensatory hyperhidrosis or other complications were observed.Postoperative follow-up ranged from 3 moths to 3 years,with an average of 18 months.There was no recurrence.The effective rate was 100％.Conclusion Endoscopic thoracic sympathectomy is a safe and effective way to treat palmar hyperhidrosis and is a procedure that can be mastered by hand surgeons without a steep leaming curve. Key words: Thoracoscopes;  Hyperhidrosis;  Sympathectomy;  Compensatory hyperhidrosis