Evaluation of Efficiency of Endoscopic trans-thoracic Sympathectomy for Primary Palmar Hyperhidrosis

Backgound: Primary hyperhidrosis is a condition of unknown etiology characterized by excessive sweating, typically on the palms of the hands, on the soles of the feet, and in the arms. The sweating response is increased by emotional stimuli, temperature, or elevated anxiety level or even spontaneously with no apparent cause. Objictive: The aim of the study is to evaluate the safety, efficacy and early and late complications of bilateral simultaneous endoscopic thoracic sympathectomy in treatment of primary hyperhidrosis. Patients and methods: Thirty patients with palmar hyperhidrosis grade 3 and 4 HDSS amenable for thoracoscopic sympathectomy were primarily managed. The study compromise 12 males and 18 females; the mean age at intervention was 20 (range 12-30) years. All were evaluated preoperatively with detailed history, full physical examination and the required investigations to confirm the diagnosis and to assess the fitness for surgery. Consent was then taken after discussing everything with the parents. Results: Immediately after sympathectomy, all patients were completely free from palm sweating (100%), in relation to the side operated upon. Three patients out of the 27 patients (11%) with associated plantar hyperhidrosis showed improvement of their plantar sweating immediately after endoscopic trans-thoracic sympathectomy (ETS), but the sweating recurred during the follow up period. Conclusion: in view of the low morbidity and zero mortality rate of this surgical technique, we recommend it as a method of treatment for palmar hyperhidrosis. Thoracic sympathectomy eliminates palmar hyperhidrosis with minimal recurrence