The Effect of T3 versus T4 Thoracoscopic Sympathectomy on Hyperhidrosis

Background: Primary hyperhidrosis is a disorder characterized by excessive sweating. However, surgical therapy is the most effective treatment for patients with primary hyperhidrosis. In between all different surgical approaches, video assisted thoracoscopic surgery (VATS) sympathectomy has been considered as a safe and minimally invasive procedure for palmer and axillary hyperhidrosis. The aim of this study was to evaluate the effectiveness of T3 vs. T4 sympathectomy regarding postoperative complications, recurrence and compensatory hyperhidrosis (CH) on 6 months follow up.

Methods: This prospective randomized study was conducted over 20 patients undergoing VATS sympathectomy diagnosed with palmar hyperhidrosis and failed medical treatment and undergoing thoracoscopic sympathectomy. Patients were divided randomly into two groups; group A (T3 sympathectomy) and group B (T4 sympathectomy).

Results: There was no significant difference between the two groups regarding the degree of treatment success, compensatory hyperhidrosis after one month and after 6 months. There was non-significant difference between the two groups regarding the recurrence, late postoperative complications and satisfaction.

Conclusions: Video-assisted T3 or T4 sympathectomy is a safe and effective procedure for treatment of palmar hyperhidrosis and T3 or T4 sympathectomy had no difference regarding to dryness and Compensatory Hyperhidrosis in follow-up for 6 months. Both techniques were effective for treating palmar hyperhidrosis with high rates of success and no recurrence for 6 months.