OBJECTIVETo evaluate the efficacy of video-assisted thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis and introduce the clinical experience in the prevention of complications.

METHODSThe clinic data of 588 cases of palmar hyperhidrosis who underwent bilateral sympathectomy from January 2003 and March 2007 was analyzed retrospectively. The curative results were compared between the T(2) levels denervation group (group A) and the T(2) levels remained denervation group (group B).

RESULTSAll operations were successfully performed under thoracoscope without severe morbidity and mortality. The curative rate of palmar hyperhidrosis was 99.8%. Accompanied axillary sweating and plantar sweating were improved in 84.0% and 71.0% patients respectively. All the patients were evaluated by a follow-up for 1 to 48 months with an average time of (20.3 +/- 2.3) months on the aspects of curative effect and occurrence of compensatory sweating. During one week after surgery, the transient postoperative hand sweating recurred in 10 cases and then disappeared within 1 to 3 days. Two cases experienced gustatory hyperhidrosis. One case experienced hand sweating at 8 th month postoperative. Side-effect of compensatory sweating were observed in 28.0 percent of group A and 13.4 percent of group B (P < 0.01).

CONCLUSIONSVideo-assisted thoracoscopic sympathectomy is an effective, safe and minimally invasive method for the treatment of hyperhidrosis. The method of T(2) levels remained denervation appears associated with less compensatory sweating.