Quality of life and patient satisfaction after video-assisted thoracic sympathicolysis for essential hyperhidrosis: a follow-up of 138 patients.

OBJECTIVES

Essential hyperhidrosis (EH) is defined as excessive functioning of the sudomotor sweat system. Definitive treatment of choice is video-assisted thoracoscopic sympathetic interruption. Success rates are high, but compensatory hyperhidrosis (CH) remains a troublesome side effect. The aim of this study was to document patient satisfaction and side effects at least 6 months after thoracoscopic sympathicolysis.

METHODS

Between 2001 and 2005, 246 patients underwent bilateral ablation of the sympathetic chain at the thoracic level T2, T3, and/or T4. Questionnaires using open questions and scoring systems were sent at least 6 months after procedure and were returned by 138 patients (56%).

RESULTS

From the 138 patients (56 males/82 females), 39 suffered from cranial (±facial blushing), 34 from palmar, and 34 from axillary hyperhidrosis. Thirty-one patients were treated for a combination. No conversion to open surgery or deaths occurred. For the whole group, average quality of life was 4.5±2.5 before and 8.4±1.8 after surgery (P<.001). Ninety-one percent were very satisfied (score ≥7) and 80% showed an increased quality of life of ≥2. Compensatory sweating occurred in 76% of the patients, only 6% reported this as disabling. Comparing subgroups, a significant improvement in primary complaint score was found in 90%, 94%, and 91% for the T2, T3, and T4 patients, respectively. In the T4 group, the prevalence of CH was markedly lower (53%) and none of these patients were dissatisfied.

CONCLUSION

Thoracoscopic ablation of the sympathetic chain is an effective treatment for EH; CH occurs in the majority of patients, but only rarely impairs postoperative quality of life.