TREATMENT OF PRIMARY PALMAR HYPERHIDROSIS WITH VIDEO-ASSISTED THORACOSCOPIC SYMPATHECTOMY IN CHILDREN: EFFECTIVENESS AND PATIENT SATISFACTION

Abstract

TYPE: Abstract Publication TOPIC: Pediatrics PURPOSE: Hyperhidrosis is an embarrassing condition. We evaluated the effectiveness of video-assisted thoracoscopic sympathectomy to relieve symptoms in children with primary palmar hyperhidrosis and assessed patient satisfaction with the procedure. METHODS: After ethical approval, 30 children (228 females, 93%%) treated with bilateral thoracoscopic sympathectomy for primary palmar hyperhidrosis at a tertiary care hospital from May 2007 to June 2017 were evaluated. Median age at the time of surgery was 12 years (min 5; max 16 years). Using two 5-mm trocars, the sympathetic T3/T4 ganglia were sectioned bilaterally and resected. A hyperhidrosis-related questionnaire was administered to all children after the surgery to assess their satisfaction. RESULTS: Two children with persistent hyperhidrosis required reoperation, which was again performed using video-assisted thoracoscopy. Complete resolution of palmar hyperhidrosis was achieved in 22 (82%) children aAt a median follow- up of 60 months (min 7; max 118 months), 22 (82%) children had achieved complete resolution of palmar hyperhidrosis. In five (18%), symptoms were reduced, but bilateral palmar hyperhidrosis persisted. Postoperative compensatory hyperhidrosis occurred in 55.6%, but was regarded as not important. In relation to satisfaction, all children were very satisfied with the final result of surgery. All stated that they would have done it again, and that they would recommend the procedure for others with primary palmar hyperhidrosis. CONCLUSIONS: Video-assisted thoracoscopic sympathectomy at T3-T4 ganglia was effective to relieve symptoms with high levels of patient satisfaction. The compensatory hyperhidrosis observed in most children did not alter the perception of improvement in symptoms. CLINICAL IMPLICATIONS: Palmar Hyperhidrosis in children. DISCLOSURE: No significant relationships. KEYWORDS: hyperhidrosis, thoracic sympathectomy, patient satisfaction