Sympathectomy in the treatment of hyperhidrosis: Is it an effective solution?

Abstract

Background: Primary hyperhidrosis affects 1-3% of the general population and occurs equally in both genders. It significantly affects the quality of life. In recent years, endoscopic thoracic sympathectomy (ETS), especially with a single-port approach, has gained popularity in the treatment of primary hyperhidrosis. This study aims to assess the efficacy and clinical outcomes of ETS surgery for primary hyperhidrosis. Materials and Methods: The data of 30 patients who underwent bilateral ETS due to primary hyperhidrosis were examined retrospectively. 25 patients treated with a single port approach were included in the study, and 5 patients treated with a double port approach were excluded from the study. Preoperative evaluations and routine tests were performed. Patients were evaluated in terms of age, gender, complications, satisfaction, compensatory sweating, and relapse. Patients' satisfaction levels were determined by telephone interviews. Results: The mean patient age was 24.16 ± 6.01 years; 56% were men and 44% were women. As complications, compensatory hyperhidrosis was observed in 12% of the patients, and mild pneumothorax was observed in 12%. No operative mortality occurred. No recurrence was observed during the long-term follow-up. In telephone surveys, 88% of patients reported satisfaction. Three patients with compensatory sweating were partially satisfied. No patient reported regret. Conclusions: We believe that ETS is an effective option in the treatment of primary hyperhidrosis, with low morbidity and high patient satisfaction rates, despite the risk of compensatory sweating.