Long-term outcomes of bilateral thoracoscopic T3 sympathectomy for primary focal hyperhidrosis in children
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Mar 2023 · 1 min read
In brief
In brief
This 7-year retrospective study of 58 pediatric patients demonstrates that bilateral T3 thoracoscopic sympathectomy achieves excellent long-term outcomes for primary palmar hyperhidrosis, with 91% follow-up and dramatic quality of life improvements from 42/100 preoperatively to 80-97/100 postoperatively. While compensatory sweating occurred in 15.5% and recurrence in 3.4%, the procedure maintained high patient satisfaction with only two patients expressing regret.
Written by the GCMD Library team from the article.
Background: Thoracoscopic bilateral T3 sympathectomy for primary focal palmar hyperhidrosis in children has excellent short-term outcomes. However, data in the literature, on the long-term outcomes of the operation are scarce.
Methods: We conducted a retrospective institutional review of all children and adolescents undergoing T3 bilateral thoracoscopic sympathectomy for primary focal palmar hyperhidrosis between June 2013 and October 2020. We composed a quality of life (QoL) questionnaire evaluating the patient's perception of how much the hyperhidrosis affected their daily life in multiple domains. The questionnaire was completed before the operation and at every postoperative follow-up visit.
Results: We operated on 58 patients with a median age of 15 (6-25) years. There were no intraoperative or postoperative complications, and all patients had immediate complete postoperative resolution of their palmar hyperhidrosis. Fifty-three patients (91.4%) had long-term follow-up data available with a median of 2.5 (range 0.1-7.5) years. Two patients (3.4%) experienced recurrence of their palmar hyperhidrosis. Nine patients (15.5%) experienced compensatory hyperhidrosis and required occasional medical management with oral anticholinergics. Two patients reported regretting having undergone the operation. Overall, the mean QoL score improved remarkably, from 42/100 before the operation to 92/100 at 1 month, 89/100 at six months to a year, 97/100 between two and four years, and 80/100 ≥ 5 years after the operation.
Conclusion: Thoracoscopic bilateral T3 sympathectomy has a high success rate for primary palmar hyperhidrosis in children in the mid- to long-term. Compensatory sweating and recurrence can occur years after the operation, so long-term follow up is mandatory.
DOI: 10.1016/j.jpedsurg.2022.09.014