Incidence of chest wall paresthesia after needlescopic video-assisted thoracic surgery for palmar hyperhidrosis

Eur J Cardiothorac Surg. 2005 Feb;27(2):313-9. doi: 10.1016/j.ejcts.2004.10.038.


Objective: Chest wall paresthesia is a reported sequela of thoracotomy and Video-Assisted Thoracic Surgery (VATS) which is distinct from wound pain. Although needlescopic VATS confers less post-operative pain and better cosmesis, the incidence of paresthesia after needlescopic VATS has not been quantified.

Methods: For homogeneity of the patient cohort, we studied 50 patients who received bilateral needlescopic VATS sympathectomy (T2-T4 excision) for palmar hyperhidrosis using 2 or 3 mm instruments during a 36-month period at a single institute. A standard questionnaire was administered by telephone interview, with 34 patents responding (68.0%). The median post-operative observation time was 16.5 months (range: 10-40 months). Collected data were compared with a historical group who received conventional VATS using 10 mm ports.

Results: Paresthetic discomfort distinguishable from wound pain was described by 17 patients (50.0%). The most common descriptions were of 'bloating' (41.2%), 'pins and needles' (35.3%), or 'numbness' (23.5%) in the chest wall. The paresthesia resolved in less than two months in 12 patients (70.6%), but was still felt for over 12 months in three patients (17.6%). Post-operative paresthesia and pain did not impact on patient satisfaction with the surgery, whereas compensatory hyperhidrosis in 24 patients (70.6%) did (P=0.001). The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS.

Conclusions: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS, but has minimal impact on post-operative satisfaction. Needlescopic VATS offers no apparent advantage over conventional VATS with regard to paresthesia.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Hand
  • Humans
  • Hyperhidrosis / physiopathology
  • Hyperhidrosis / surgery*
  • Male
  • Middle Aged
  • Pain, Postoperative / etiology
  • Paresthesia / etiology*
  • Patient Satisfaction
  • Remission, Spontaneous
  • Retrospective Studies
  • Sympathectomy / methods
  • Thoracic Surgery, Video-Assisted / adverse effects*
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracic Wall*