June 1994

Transthoracic Endoscopic Sympathectomy in the Treatment of Palmar Hyperhidrosis

Author Affiliations

From the Departments of Surgery (Drs Chen and Shih) and Anesthesiology (Dr Fung), Chang Gung Medical College and Memorial Hospital at Kaohsiung, Taiwan, Republic of China.

Arch Surg. 1994;129(6):630-633. doi:10.1001/archsurg.1994.01420300074011

Objective:  Transthoracic endoscopic electrocauterization of the sympathetic chain for palmar hyperhidrosis is presented.

Design:  A retrospective study of 180 patients during a 2-year period was carried out. The duration of follow-up was from 2 to 12 months.

Setting:  General community, referral center, and hospitalized care.

Patients:  This study was carried out in 180 patients (116 female and 64 male). The age distribution was between 13 and 43 years (mean age, 21.6 years). They complained of palmar hyperhidrosis without other underlying diseases.

Interventions:  One-stage bilateral surgery except for three patients with unilateral pleural adhesions.

Main Outcome Measures:  Patients were interviewed 1 week after surgery and then they were contacted by a questionnaire about improvement of hyperhidrosis and complications.

Results:  This procedure shows a success rate in 98% of the patients. No pneumothorax requiring a chest tube drainage and no Horner's syndrome were recorded. The most common side effect was compensatory sweating in 70% of these patients.

Conclusion:  This procedure is effective, simple, and requires only an overnight study. It is recommended as the method of choice for surgical treatment of upper extremity hyperhidrosis.(Arch Surg. 1994;129:630-633)