Thoracoscopic sympathicotomy for disabling palmar hyperhidrosis: a prospective randomized comparison between two levels.

摘要: Background Thoracoscopic sympathicotomy is highly effective in treating disabling palmar hyperhidrosis. The ideal level to maximize efficacy and minimize the side effect of compensatory hyperhidrosis (CH) controversial. This study compared over second (R2) vs third (R3) costal head relative these variables patients with massive Methods prospective, randomized enrolled 121 palmoplantar assigned bilateral (sympathetic transection), which was done R2 61 (n = 122 extremities) or R3 60 120 extremities). Patients were questioned at 6 months 1 year more assess efficacy, effects, satisfaction procedure. Results Sympathicotomy failed cure 5 (4.1%) extremities, but only 2 (1.6%) a truly profound dripping recurrence. extremities (4.2%), all dramatic failures recurrent sweating. whose not completely cured aged 19.7 ± 2.5 26.4 8.0 years ( p 0.04). Two failure underwent three redo sympathicotomies, curative results. showed trend toward higher CH after year. severity scale 4.7 2.7 38) for 3.8 2.8 36) NS) 43) 3.7 37) Younger age, male sex, levels preoperative postoperative plantar sweating predictors sympathicotomy. Increased age associated increased CH. Conclusions are effective, low recurrence incidences severe tends have R3, incidence suggested patients, reoperation will likely be curative.