The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Late results of endoscopic thoracic sympathectomy for hyperhidrosis and facial blushing. BJS 2011; 98: 1719-1724.

Published: 16th September 2011

Authors: K. Smidfelt, C. Drott

Background

The purpose of this study was to clarify the long‐term effects, side‐effects and overall satisfaction rates of endoscopic thoracic sympathectomy (ETS) used in the treatment of hyperhidrosis and facial blushing.

Method

Some 3015 patients had bilateral ETS from 1989 to 1998. A questionnaire follow‐up was used. Some of the patients had participated in a previous follow‐up study, and the answers in both surveys were compared.

Results

A total of 1700 patients responded (56·4 per cent); mean(s.d.) follow‐up was 14·6(2·4) years. The best result was achieved for palmar hyperhidrosis (95·6 per cent) compared with axillary hyperhidrosis (68·9 per cent), facial hyperhidrosis (83 per cent) and facial blushing (72·8 per cent) (P < 0·001). Compensatory sweating, the main side‐effect, was present in 80·0 per cent. Some 6·5 per cent were dissatisfied and 13·5 per cent regretted having the procedure. Patients with palmar hyperhidrosis were more satisfied (86·6 per cent) than those with axillary hyperhidrosis (66·0 per cent), facial hyperhidrosis (74 per cent) or facial blushing (73·5 per cent) (P < 0·001). Women were more satisfied than men (85·4 versus 71·4 per cent; P < 0·001). The procedure regret rate rose from 7·8 per cent in the first survey to 13·5 per cent in the present one.

Conclusion

ETS had an excellent and lasting effect on palmar hyperhidrosis. The effect on facial and axillary hyperhidrosis and facial blushing was less rewarding. The procedure regret rate increased over time. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Full text