Endoscopic Thoracic Sympathectomy for the Treatment of Hyperhidrosis

Although hyperhidrosis is regarded as a benign sympathetic disorder, it can have a significant psychosocial impact on affected individuals while markedly affecting their quality of life (QoL).

We aimed to evaluate the effects of endoscopic thoracic sympathectomy (ETS) on the treatment of primary hyperhidrosis and patients’ QoL).

This prospective interventional study included patients with primary hyperhidrosis referred to Shahid Mohammadi Hospital, Bandar Abbas, Iran, for ETS during 2012-2019. General characteristics including age, sex, and body mass index (BMI) were recorded for all patients. All participants underwent ETS by a single experienced surgeon. Patients were evaluated twice; once before the procedure and once one month after the procedure. The sites of hyperhidrosis, Hyperhidrosis Disease Severity Scale (HDSS), and QoL were the evaluated variables. Patients’ satisfaction, compensatory hyperhidrosis, and procedural complications such as pneumothorax were also assessed on follow-up.

From the 47 patients evaluated in this study with a mean ± SD age of 28.2±1.21 years, 27 (57.4%) were men. No patient experienced compensatory hyperhidrosis and procedural complications after the procedure. Also, 45 (95.7%) patients were 100% satisfied and 2 (4.3%) were 90% satisfied with the procedure. There was a significant reduction in the number of hyperhidrosis sites and HDSS score after one month compared with baseline (P=0.006 and P<0.001, respectively). Moreover, the QoL significantly improved after the procedure (P<0.001).

ETS appears to be very safe and effective for the treatment of primary hyperhidrosis in terms of the reduction of hyperhidrosis sites and HDSS score, as well as improving QoL and patient satisfaction.