Quality of life and patient satisfaction after single port endoscopic thoracic sympathectomy for primary focal hyperhidrosis: A follow-up of 250 patients

Abstract

Abstract Background If left untreated, severe types of Primary Focal Hyperhidrosis (PFH) would negatively affect patients' quality of life (QoL). The aim of this study is to determine the efficacy of Endoscopic thoracic sympathectomy (ETS) and the degree of improvement in quality of life and satisfaction after surgery. The intraoperative and postoperative complications were evaluated, especially compensatory hyperhidrosis (CH). We hypothesized that the selected sympathectomy level will neither prevent nor reduce CH. Methods a single-center retrospective study of 250 adult patients diagnosed with bilateral PFH underwent ETS of the 2nd ,3rd, and 4th thoracic sympathetic ganglion. We compared pre-and-post operative HDSS and QoL using Pearson correlation. The rate of CH and other complications during follow-up of 4 years were recorded. Results Among 250 patients 217 had a preoperative hyperhidrosis severity score (HDSS) of 3 and 33 patients had a score of 4 compared to postoperative HDSS was zero in 145 patients (58%), 1 in 82 patients (32.8%), 2 in 22 patients (8.8%), and score 3 in one patient (0.4%) P value (0.097). QoL before operation in 201 patients was very bad (80.4%) while postoperatively QoL was much better in 206 patients (82.4%) P value (0.0001). CH was seen only in 27 patients (10.8%), and only one was severe. Conclusion ETS is safe and effective for severe cases of PFH. Sympathectomy at 2nd ,3rd, and 4th ganglion levels has an excellent outcome and patient satisfaction with minimal perioperative complications including compensatory hyperhidrosis.