Objective To examine the relation between compensatory sweating（CS） and the resection site of the sympathetic nerve china during sympathectomy in treatment of palmal hyperhidrosis and thus to investigate the potential mechanism of the occurrence of compensatory sweating. Methods From October 2004 to December 2005, 128 patients with primary palmar hyperhidrosis were randomly divided into two groups： 61 with T3 sympathicectomy （T3 group） and 67 with T4 sympathicectomy （T4 group）. All were treated under general anesthesia, single lumen intubation and via intercostal mediastinoscopic surgery. Results No morbidity or mortality occurred. Sweating of target organs was cured in all cases. Rates of minor CS in Group T3 or T4 showed no statistically significant （χ^2 = 1.866, P = 0.122）. Rate of moderate CS in group T4 was significantly lower than that in group T3 （χ^2=7.618, P=0.006）. No severe CS occurred. Conclusion Occurrence rate and severity of compensatory sweating are lower in T4 resection than in T3.
ObjectiveTo investigate the feasibility and clinical outcomes of bilateral endoscopic thoracic sympathectomy (ETS) through single hole for palmar hyperhidrosis (PHH). MethodsFrom August 2012 to April 2013, 19 PHH patients were admitted in the Department of Thoracic Surgery, The Third People's Hospital of Chengdu. There were 7 male and 12 female patients with their age of 24.7(15-33) years. All the patients underwent bilateral ETS through single hole under general anesthesia. ResultsAll the operations were successfully performed. Average operation time was 28.4 minutes, and postoperative hospital stay was 1.6 days. Seventeen patients were followed up for 2 to 10 months. PHH symptoms all disappeared without Horner's syndrome or hemopneumothorax. ConclusionBilateral ETS through single hole is a minimally invasive, reliable and safe procedure for PHH with low morbidity.
ObjectiveTo assess the feasibility and safety of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis. MethodsFrom March 1, 2018 to February 1, 2021, 90 patients with primary palmar hyperhidrosis who underwent ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy at the Thoracic Surgery Department of the University of Hong Kong-Shenzhen Hospital. There were 47 males and 43 females, with a median age of 26.0 (22.0, 31.0) years. During the operation, T3 and/or T4 thoracic sympathetic nerve chain was transected using an ultra-micro 5 mm single-port incision near the areola or under the axilla. The surgical data of the patients were retrospectively reviewed and analyzed. Results All patients successfully completed the operation without major bleeding during the operation and no conversion to thoracotomy. There was no death or serious complication during the perioperative period. The operation time was 43.0 (23.0, 60.0) min, and the intraoperative blood loss was 2.0 (1.0, 2.0) mL. In the perioperative period, only one patient needed a tiny chest tube indwelling. The symptoms of hyperhidrosis on the hands all disappeared after the operation. The pain score on the postoperative day was 2.0 (2.0, 2.0) points. The hospital stay after surgery was 1.0 (1.0, 1.0) d. In the first month after the operation, the symptoms of hyperhidrosis on the hands were significantly relieved compared with those before the operation. The surgical incisions healed well, the wounds were concealed, and there was no wound infection or poor healing. The patients' satisfaction with the surgical incisions was 100.0%. After the operation, 14 (15.6%) patients had mild compensatory hyperhidrosis, 5 (5.6%) patients had moderate compensatory hyperhidrosis, and no patient had severe compensatory hyperhidrosis. Overall satisfaction rate was 94.0%. Conclusion The clinical application of ultra-micro 5 mmsingle-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis is safe and feasible. The surgical wound is extremely small and hidden, the operation time is short, the pain is very slight, and the clinical outcome is good. It can fully meet the patients' pursuit of beauty.