Abstract
Background and Objective Primary palmar hyperhidrosis that arises mostly during puberty and early adolescence
has a tremendous impact on the quality of life in patients. This study aimed to investigate
the effectiveness of unilateral video-assisted thoracic sympathectomy for dominant
hand in these patients.
Patients and Methods From July 2010 to June 2013, 52 patients with primary palmar hyperhidrosis underwent
unilateral video-assisted thoracoscopic sympathectomy for dominant hand. We analyzed
the outcomes regarding the resolution of symptoms, occurrence of complications, recurrence
rate, and compensatory hyperhidrosis, and need of operation for opposite side.
Findings All patients were followed up from 6 to 42 months. Palmar hyperhidrosis was completely
alleviated and absolute dryness was achieved in all patients at the same hand after
the operation. Palmar hyperhidrosis in the opposite hand was cured to a complete dryness
in 24 (46.15%) patients. No change happened in the opposite hand in 22 (42.3%) patients,
but an increase was seen in 6 (11.53%) patients. Only seven (13.46%) patients needed
to undergo contralateral sympathectomy. Compensatory hyperhidrosis occurred in 13
patients (25%) after unilateral sympathectomy. Another five patients (totally 18,
34.6%) were involved with compensatory hyperhidrosis after contralateral sympathectomy.
It was mainly on the trunk in all 18 patients.
Conclusion Unilateral dominant side thoracoscopic sympathectomy for patients with primary palmar
hyperhidrosis is an effective, safe, and minimally invasive procedure. Only a small
number of patients will eventually require a contralateral sympathectomy in nondominant
hand.
Keywords
primary hyperhidrosis - sympathectomy - unilateral - palmar hyperhidrosis
