Mid-term results of endoscopic thoracic sympathectomy at Dong Nai General Hospital

Abstract

Introduction: Primary hyperhidrosis is caused by overactivity of the sympathetic nervous system, causing localized hyperhidrosis, commonly found in the palms, soles, armpits and sometimes on the face. Currently, there are many methods to treat hyperhidrosis, however, for severe hyperhidrosis at levels 3 and 4, surgery is the preferred method.

Methods: Case series report, retrospective of patients undergoing endoscopic thoracic sympathectomy at Dong Nai general hospital. Patients who met the criteria would be contacted and included in the study.

Results: There were 43 patients included in the study from January 2022 to December 2023. Mean age was 28.1, the proportion of men was 46.5%. Most of the disease onset was in childhood (81.4%), patients mainly worked with hands (65.1%). The level of severe hyperhidrosis grade 4 accounted for a large proportion of 81.4%. The average surgical time was 35 ± 8.4 minutes. No serious postoperative complications were recorded, 2.3% of cases recorded postoperative pneumothorax requiring drainage. 100% of patients had complete reduction of hyperhidrosis immediately after surgery and after 1 year, the rates of no sweating and grade 2 sweating were 83.7% and 16.3%, respectively, with no cases of grade 3 or grade 4 recorded. There were no cases of severe compensatory hyperhidrosis immediately after surgery and at 1 year, the rate of severe compensatory hyperhidrosis was about 15%. The rates of patients who were very satisfied, partly satisfied and not satisfied were 48.8%, 37.2%, 14%, respectively.

Conclusion: Endoscopic thoracic sympathectomy is a safe procedure with high early and mid-term treatment effectiveness, helping to improve the patient's postoperative quality of life. However, the rate of compensatory sweating is still high (10-15% of severe compensatory sweating), posing many challenges in the treatment of this disease.