Micro-double-port endoscopic thoracic sympathectomy for treatment of primary palmar hyperhidrosis: report of 25 cases

Abstract

Objective To summarize the clinical application of micro-double-port endoscopic thoracic sympathectomy in treatment of primary palmar hyperhidrosis. Methods Clinical data of 25 patients with primary palmar hyperhidrosis undergoing sympathectomy in our department from April 2021 to March 2022 were collected and retrospectively analyzed. They were 9 males and 16 females, at an age of 23.0±5.1 (15, 35) years. During the operation, two 0.5-cm incisions were made at the anterior axillary line and the mid-axillary line of the 3rd or 4th intercostal space, then two 5-mm trocars were placed, and a 5-mm needle-type thoracoscope was used to establish an artificial pneumothorax. R3 and R4 thoracic sympathetic chains were transected. Results All 25 patients successfully received the operation and were discharged upon recovery. One patient developed a small amount of pneumothorax on the right side after operation, and re-examination with chest X-ray filming showed that the pneumothorax was absorbed in 12 d after operation. The symptoms of hyperhidrosis on the hands all disappeared, and hand temperature was increased as expected. The operation time was 23.2±4.7 min, the intraoperative blood loss was 4.2±2.3 mL, the postoperative hospital stay was 0.6±0.4 d, and the postoperative pain score was 1.0±0.6. The treatment effective rate was 100%, and the satisfaction of outcome was 100%. Fifteen patients had mild compensatory hyperhidrosis postoperatively. Conclusion In treatment of primary palmar hyperhidrosis, micro-double-port endoscopic thoracic sympathectomy is characterized by small incision, safe and easy operation, short operation time and postoperative hospital stay, and no obvious pain and more satisfying outcomes.

Keywords

• micro-double-port approach
• primary palmar hyperhidrosis
• video-assisted thoracoscopy
• endoscopic thoracic sympathectomy