There is general consensus that the optimal definitive treatment for severe essential hyperhidrosis (EH) in adults consists of (video-assisted) thoracoscopic ablation of the upper thoracic sympathetic ganglia T2 (and T3). Little is known about the definitive treatment of severe EH in children. The objective of this study is to compare a simplified minimally invasive thoracoscopic T2-T3 sympathicolysis technique (TS), performed by a pneumologist, in children and adults suffering from severe EH. Two hundred consecutive patients with severe EH. treated from August 1993 to August 1997, including 18 children (13.2 ± 2 years, range 7 to 15 years) and 182 adults (30.4 ± 10.8 years, range 16 to 67 years), were included in the study. Clinical efficacy, side effects, complications, and patient satisfaction were assessed in the group of children and adults, respectively. TS was proven equally effective in children as in adults (100% vs. 98% relief of palmar hyperhidrosis, respectively; 0% vs. 2% recurrence during a follow-up of 19 ± 12 vs. 18 ± 13 months), with a comparable incidence of side effects, a total absence of major complications, and 100% patient satisfaction. These results are better than historical data obtained after open surgical approaches and equal to those obtained by a (slightly more complicated) video-assisted thoracic surgery method using lasers. We conclude that TS is as safe and efficient in children with severe EH as in adults.
© 1999 Lippincott Williams & Wilkins, Inc.