Thoracoscopic resympathectomy for persistent or recurrent palmar hyperhidrosis: single-center experience

Gen Thorac Cardiovasc Surg. 2022 Jul;70(7):651-658. doi: 10.1007/s11748-022-01788-5. Epub 2022 Feb 23.

Abstract

Background: In case of recurrence or persistent palmar hyperhidrosis, a sympathetic chain resection is suggested, however, many surgeons are still reluctant to offer further intervention because of the inability to predict the efficacy of such a procedure. We analyzed our large series of resympathectomy.

Methods: Substantive retrospective analysis of 39 patients underwent a resympathectomy (minimally invasive bilaterally sympathetic chain Th2-3 resection). Patients referred from other hospitals or primarily operated at our institution for recurrence or persistence palmar hyperhidrosis were included in the study group.

Results: No intraoperative complications were detected. Reoperation or chest tube positioning was necessary in 2 patients. Twenty-eight patients had a positive response (excellent or good results). Seven patients described a substantial, but not sufficient, reduction of the symptomatology. Four patients were very unsatisfied and regretted the operation.

Conclusions: Resympathectomy is highly effective procedure for patients who have persistent or recurrent symptoms. However, the indication of the operations should be more dissuasive as possible to avoid the risk of any undesirable psychologically side effects.

Keywords: Complication; Hyperhidrosis; Recurrence; Surgery; Sympathectomy.

MeSH terms

  • Hand / surgery
  • Humans
  • Hyperhidrosis* / surgery
  • Reoperation
  • Retrospective Studies
  • Sympathectomy* / adverse effects
  • Sympathectomy* / methods
  • Thoracoscopy / adverse effects
  • Thoracoscopy / methods
  • Treatment Outcome