Compensatory sweating after thoracoscopic sympathectomy for primary hyperhidrosis: single institute experience

Objective: To investigate the incidence and impact of compensatory sweating (CS) after thoracoscopic sympathectomy (TS) for primary hyperhidrosis. Methods: From June 1994 to February 2005, bilateral TS were performed for 50 patients with primary hyperhidrosis. A questionnaire to evaluate the outcome of hyperhidrosis, the severity of postoperative compensatory sweating, and its impact on social function was conducted via telephone interview in May 2005. A scoring system from zero to 100% was used to quantify the outcome of hyperhidrosis. The effect on social function and level of satisfaction with the outcome of TS was assessed. Results: Thirty-six patients completed the questionnaire (overall response rate 72%). The mean age was 28 years. Thirty-four patients experienced improvement in primary hyperhidrosis within the first week after TS and 35 patients experienced sustainable symptomatic improvement on long-term follow up. Compensatory sweating occurred in 31 patients (86%). Nineteen of 26 patients (73%) who had been followed up for more than 1 year experienced no change in CS. Five other patients had worsening of CS over time. Only two patients reported either improvement or resolution of CS during the study period. Nevertheless, CS had no or a mild effect on the social function in the majority of patients (68%) and most patients (94%) were satisfied with the outcome of the operation. Conclusion: Thoracoscopic sympathectomy is an effective treatment for primary hyperhidrosis. Despite the frequent occurrence and persistence of compensatory sweating, thoracoscopic sympathectomy was considered by most patients to be a satisfactory treatment option for this disturbing condition.