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Comparing two methods of thoracoscopic sympathectomy for palmar hyperhidrosis

Ibrahim, Magdi MD; Allam, Abdulla FRCS

Journal of the American Academy of Physician Assistants: September 2014 - Volume 27 - Issue 9 - p 1–4
doi: 10.1097/01.JAA.0000453237.17130.6b
Original Research

Background: Hyperhidrosis can cause significant professional and social handicaps. Thoracic endoscopic sympathectomy has become the surgical technique of choice for treating intractable palmar hyperhidrosis and can be performed through multiple ports or a single port. This prospective study compares outcomes between the two methods.

Methods: The study followed 71 consecutive patients who underwent video-assisted sympathectomy for palmar hyperhidrosis between January 2008 and June 2012. In all patients, the procedure was bilateral and performed in one stage. The multiple-port method was used in 35 patients (group A) and the single-port method in 36 patients (group B). Preoperative, intraoperative, and postoperative variables; morbidity, recurrence; and survival were compared in both groups.

Results: The procedure was successful in 100% of the patients; none experienced a recurrence of palmar hyperhidrosis, Horner syndrome (oculosympathetic palsy), or serious postoperative complications, and none died. No patients required conversion to an open procedure. Residual minimal pneumothorax occurred in two patients (5.7%) in group A and in one patient (2.8%) in group B. Minimal hemothorax occurred in one patient (2.9%) in group A and in three patients (8.3%) in group B. Compensatory hyperhidrosis occurred in seven patients (20%) in group A and in eight patients (22.2%) in group B.

Conclusion: No difference was found between the multiple- and single-port methods. Both are effective, safe minimally invasive procedures that permanently improve quality of life in patients with palmar hyperhidrosis.

Magdi Ibrahim and Abdulla Allam practice in the Department of Thoracic Surgery at King Fahd Hospital in Al-Madina Al-Munawara, Saudi Arabia. Dr. Ibrahim also is on the faculty of medicine in the Department of Cardio-Thoracic Surgery at Suez Canal University in Egypt. The authors have disclosed no potential conflicts of interest, financial or otherwise.

© 2014 American Academy of Physician Assistants.