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. 2024 Oct 4;19(1):590.
doi: 10.1186/s13019-024-03086-y.

Long term outcomes and risk factors of compensatory hyperhidrosis after thoracoscopic sympathectomy in primary palmar hyperhidrosis patients: a retrospective single-center study

Jianxin Xu #  1 , Weicheng Liang #  2 , Jianxin Cai  1 , Junkai Xiong  1 , Chengbin Huang  1 , Zhiyang Xu  3 , Jun Guan  4
Affiliations

Long term outcomes and risk factors of compensatory hyperhidrosis after thoracoscopic sympathectomy in primary palmar hyperhidrosis patients: a retrospective single-center study

Jianxin Xu et al. J Cardiothorac Surg. .

Abstract

Objective: This study aims to evaluate the long-term outcomes of compensatory hyperhidrosis (CH) after thoracoscopic sympathectomy and explore the risk factors affecting postoperative CH in primary palmar hyperhidrosis(PPH) patients.

Method: A retrospective analysis was conducted on patients who underwent thoracoscopic sympathectomy in the thoracic surgery department of our hospital from January 2015 to May 2022. Long-term follow-up surveys was conducted to collect data on post-operative satisfaction, PPH recurrence, and CH occurrence. Postoperative CH outcomes were assessed using the HDSS and satisfaction scores scale. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for postoperative CH.

Result: A total of 152 patients was included in the final study, with 113 cases in the CH group and 39 cases in the nCH group. The incidence of postoperative CH was 74.3% (113/152), within which 33.6% (38/113) were severe CH. The median follow-up time was 3.1 years(2.5-5.5y) and the median interval of CH onset after surgery was 30 days (14-90d). Univariate analysis showed that body mass index(BMI), surgical time, and transected nerve level are correlated with CH, with statistically significant differences. Multivariate logistic regression analysis indicated a higher BMI (OR = 0.864, 95% CI 0.755-0.989, P < 0.05) is the independent risk factor for the occurrence of CH. There was no statistically significant difference in HDSS scores among CH patients at 1 month, 1 year, and 3 years after surgery.

Conclusion: A higher BMI is the independent risk factor for postoperative CH after thoracoscopic sympathectomy. The incidence and severity of postoperative CH kept stable during a long term follow up.

Keywords: Body mass index; Compensatory hyperhidrosis; Primary palmar hyperhidrosis; Thoracoscopic sympathectomy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A. Surgical position for ETS; B. Location of surgical incision (third intercostal space of the anterior axillary line)
Fig. 2
Fig. 2
surgical process of thoracoscopic T3 nerve sympathectomy. A. The THIRD rib is located and the sympathetic chain identified;B. Cauterization of T3 sympathetic nerve chain; C. Extend cauterization area to 2 cm aside the R3 rib surface to ensure a completed cut off of the Kuntz nerve and sympathetic communicating branch; D. A drainage tube is inserted into chest cavity with the distal end placed into water for air exhausting
Fig. 3
Fig. 3
Flowchart of the study
Fig. 4
Fig. 4
Postoperative satisfaction between CH group and nCH group
See this image and copyright information in PMC

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