Endoscopic expanded sympathotomy for the treatment of extremely severe compensatory hyperhidrosis: A case report_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 TU Yuanrong ^1,2 ,  DU Quan ^1,2 , CHEN Jianfeng ^1,2 , LIN Min ^1,2 , FENG Zhi ^1,2

1. Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, P. R. China;
2. Department of Thoracic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, Fuzhou, 350212, P. R. China;

Corresponding author：

TU Yuanrong, Email: tuyuanrong@Hotmail.com; DU Quan, Email: 49997929@qq.com

Keywords：

Palmar hyperhidrosis; compensatory hyperhidrosis; expanded sympathotomy; thoracoscopy; case report

DOI：

10.7507/1007-4848.202403035

Video：

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Compensatory hyperhidrosis (CH) is a severe side effect that occurs after endoscopic thoracic sympathotomy (ETS) for the treatment of palmar hyperhidrosis. CH significantly interferes with daily activities such as work, study, and social interactions, leading to a substantial decrease in the quality of life for patients. Preventing and treating CH are currently important and challenging issues in minimally invasive surgery for palmar hyperhidrosis. In this report, we presented a 29-year-old male patient who experienced severe CH for 8 years following ETS. The patient underwent staged unilateral endoscopic expanded sympathotomy (ES) at our hospital on December 11, 2023 and January 3, 2024, targeting the R4-R10 levels. After a 3-month follow-up, the patient experienced significant improvement in clinical symptoms and quality of life, with no recurrence of palmar hyperhidrosis or other complications. The treatment outcome was satisfactory.

Citation： TU Yuanrong, DU Quan, CHEN Jianfeng, LIN Min, FENG Zhi. Endoscopic expanded sympathotomy for the treatment of extremely severe compensatory hyperhidrosis: A case report. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(7): 1071-1073. doi: 10.7507/1007-4848.202403035 Copy

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9.	Yamamoto H, Okada M. The management of compensatory sweating after thoracic sympathectomy. J Thorac Cardiovasc Surg, 2019, 158(5): 1481-1488.
10.	Vasconcelos CFM, Aguiar WS, Tavares RM, et al. Bilateral R5-R8 sympathectomy for compensatory hyperhidrosis: Complications and patients satisfaction. Rev Col Bras Cir, 2020, 47: e20202398.
11.	Han JW, Kim JJ, Kim YH, et al. New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis. J Thorac Dis, 2020, 12(3): 765-772.
12.	Jae KP, Moon MH, Hyun K, et al. Surgical treatment of facial blushing patient selection and operative technique (retrospective observational study). Medicine, 2022, 101(27): e29808.
13.	林清财, 林建波, 涂远荣, 等. 243例原发性手汗症患者胸腔镜下交感神经切断术后生活质量分析. 中国胸心血管外科临床杂志, 2022, 29(3): 294-300.

1. Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med, 1998, 28(3): 551-558.
2. 涂远荣, 刘彦国. 中国手汗症微创治疗临床指南 (2021年版). 中国胸心血管外科临床杂志, 2021, 28(10): 1133-1139.
3. Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
4. Hajjar WM, Al-Nassar SA, Al-Sharif HM, et al. The quality of life and satisfaction rate of patients with upper limb hyperhidrosis before and after bilateral endoscopic thoracic sympathectomy. Saudi J Anaesth, 2019, 13(1): 16-22.
5. Akil A, Semik M, Fischer S. Efficacy of miniuniportal video-assisted thoracoscopic selective sympathectomy (ramicotomy) for the treatment of severe palmar and axillar hyperhidrosis. Thorac Cardiovasc Surg, 2019, 67(5): 415-419.
6. Moon MH, Hyun K, Park JK, et al. Surgical treatment of compensatory hyperhidrosis: Retrospective observational study. Medicine (Baltimore), 2020, 99(42): e22466.
7. Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
8. Gebitekin C, Melek H, Cetinkaya G, et al. Intercostal nerve reconstruction for severe compensatory hyperhidrosis: The Gebitekin technique. Ann Thorac Surg, 2021, 111(6): e443-e446.
9. Yamamoto H, Okada M. The management of compensatory sweating after thoracic sympathectomy. J Thorac Cardiovasc Surg, 2019, 158(5): 1481-1488.
10. Vasconcelos CFM, Aguiar WS, Tavares RM, et al. Bilateral R5-R8 sympathectomy for compensatory hyperhidrosis: Complications and patients satisfaction. Rev Col Bras Cir, 2020, 47: e20202398.
11. Han JW, Kim JJ, Kim YH, et al. New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis. J Thorac Dis, 2020, 12(3): 765-772.
12. Jae KP, Moon MH, Hyun K, et al. Surgical treatment of facial blushing patient selection and operative technique (retrospective observational study). Medicine, 2022, 101(27): e29808.
13. 林清财, 林建波, 涂远荣, 等. 243例原发性手汗症患者胸腔镜下交感神经切断术后生活质量分析. 中国胸心血管外科临床杂志, 2022, 29(3): 294-300.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Endoscopic expanded sympathotomy for the treatment of extremely severe compensatory hyperhidrosis: A case report

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