Abstract

Background: Primary hyperhidrosis is a condition caused by an excessive stimulation of sweat glands, leading to a decline in both quality of life and social wellbeing. Thoracic sympathectomy surgery provides a relief of the initial symptoms but poses a risk for developing compensatory hyperhidrosis in various degrees.

Objective: The aim of this study was to assess the occurrence and characteristics of compensatory hyperhidrosis post thoracic sympathectomy.

Methods: A retrospective cohort study of patients who underwent video-assisted thoracic sympathectomy surgery at level T2-T3 between 2016 and 2022 was conducted. Patients' data was retrieved from medical records and through a telephone interview.

Results: A total of 50 patients (32 males and 18 females) were operated on with a mean ± SD age of 25.9 ± 7.4 years at the time of surgery for palmoplantar hyperhidrosis. Initial symptoms started in childhood at a mean ± SD age of 11.4 ± 3.3 years. Postoperatively, 39 patients (78%) developed compensatory hyperhidrosis, more prevalent in males (64.1%) compared to females (35.8%). This compensatory hyperhidrosis mainly affected the back and abdomen (100%), followed by the groin and thighs (28.2%), and, to a lesser extent, the craniofacial area (15.3%). Onset of symptoms occurred within one week after surgery in 71.7% of cases, with 71.7% reporting mild to moderate symptoms. Compensatory hyperhidrosis was significantly associated with higher age at the time of surgery, smoking status, and a longer time lapse in the surgery operation (p value <0.05).

Conclusions: Thoracic sympathectomy is an effective procedure with a high success rate. Despite a relatively higher occurrence of compensatory hyperhidrosis, most patients experience milder symptoms and express satisfaction, noting that their expectations were met following the surgery.

Title

Annals of Vascular Surgery

Publisher

ELSEVIER

Publisher Country

Germany

Indexing

Scopus

Impact Factor

1.4

Publication Type

Both (Printed and Online)

Volume

108

Year

2024

Pages

317-324