Long term outcome of Video-Assisted Thoracoscopic Sympathectomy at thoracic level (R2-3) versus (R2-4) on Plantar Hyperhidrosis associated with Primary Palmar Hyperhidrosis

Long term outcome of Video-Assisted Thoracoscopic Sympathectomy at thoracic level (R2-3) versus (R2-4) on Plantar Hyperhidrosis associated with Primary Palmar Hyperhidrosis

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Background: Hyperhidrosis is unnecessary sweating afar the body needs for cooling down the body temperature.It affects nearly 2-3% of the population with equal gender predominance.Both medical and surgical interventions have been utilized to treat primary hyperhidrosis.Over 80% of patients with palmar Water Jug Outlet Cock hyperhidrosis (PH) also experience plantar hyperhidrosis (PLH).

An interesting observation in surgically treated patients with PH is that PLH symptoms tend to decrease after undergoing Video-assisted thoracoscopic surgery (VATS).Objectives: The aim of the present study was to evaluate the efficacy, safety and drawbacks of VATS sympathectomy at thoracic levels (R2-3) versus (R2-4) on PLH associated with primary PH.Patients and methods: this single center, parallel randomized controlled study involved 72 eligible patients presented Baby Shampoos with primary palmoplantar hyperhidrosis, where 36 patients underwent VATS sympathectomy at thoracic levels R2-3 (Group A) versus other 36 patients at thoracic level R2-4 (Group B).Both groups underwent bilateral two-port tubeless VATS sympathectomy with the use of electrocautery under general anesthesia in semi-fowler position.

Results: Following surgery, both groups showed improvement in PLH, but group B had a significantly higher incidence of improvement compared to group A.In group A, 77.7% of patients were satisfied, while in group B, 88.8% of patients reported satisfaction.

Conclusion: VATS sympathectomy is the preferred treatment for effectively curing PH.There is a significant correlation between VATS sympathectomy performed at the R2 to R4 levels and the alleviation of PLH.