Bilateral single-port sympathectomy: long-term results and quality of life

Biomed Res Int. 2013;2013:348017. doi: 10.1155/2013/348017. Epub 2013 Dec 8.

Abstract

Object: Video-assisted thoracoscopic sympathectomy is a safe, effective, and minimally invasive procedure for primary hyperhidrosis. This study aims to evaluate long-term results and patients' quality of life and investigate potential variables responsible for compensatory sweating after one-stage bilateral single-port thoracoscopic sympathectomy.

Methods: Between 2005 and 2011, 260 consecutive bilateral thoracoscopic sympathectomies were performed in 130 patients for primary palmar and axillary hyperidrosis through one-port access. Residual pain, postoperative complications, recurrence of symptoms, heart rate adjustment, and quality of life were analyzed. Multivariate analysis was performed.

Results: No operative mortality and conversion to open surgery were recorded. Mean operative time was 38 ± 5 minutes. Mean hospital stay was 1.1 ± 0.6 days. Eight patients (6%) had unilateral pneumothorax. Twenty-five cases (19%) were complicated by compensatory sweating. Winter and fall were identified as protective factors for compensatory sweating occurrence. Decreased heart rate was observed 1 year after surgery and permanently over the time. No recurrence during the follow-up period (31.5 months) was observed and 90% of patients showed improved quality of life.

Conclusions: One-stage bilateral miniuniportal thoracoscopic sympathectomy is a valid and safe treatment for primary hyperhidrosis, achieving definitive and esthetic results, with excellent patients' satisfaction. Compensatory sweating may potentially occur in a season-dependent manner.

MeSH terms

  • Adult
  • Female
  • Humans
  • Hyperhidrosis / epidemiology
  • Hyperhidrosis / pathology
  • Hyperhidrosis / surgery*
  • Male
  • Middle Aged
  • Palmar Plate / surgery
  • Patient Satisfaction
  • Quality of Life*
  • Surveys and Questionnaires
  • Sympathectomy / methods*
  • Thoracic Surgery, Video-Assisted / methods*
  • Treatment Outcome