Improvement in quality of life after bilateral transthoracic endoscopic sympathectomy for palmar hyperhydrosis.

Abstract

OBJECTIVE: To evaluate the efficacy of bilateral transthoracic endoscopic sympathectomy (TES), in alleviating symptoms and improving quality of life for patients in Hawaii. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: Patients who had undergone TES were evaluated by phone interview and the SF-36 questionnaire to assess improvements in symptoms and the development of compensatory hyperhydrosis. SF-36 scores were divided into 8 scales and evaluated by one-tailed t-test. RESULTS: Since 1999, eight patients (five women and three men, mean age 27.4 years old, range 15-41 yrs) underwent TES without significant complication. Length of hospital stay was less than one day for all patients except one, who stayed four days. Estimated operative blood lost was less than 100 ml and no blood transfusions were required. No Horner's syndrome was suffered. After a mean follow-up of 7.0 months (range 1.2-15.8 months), none of the patients had recurrent symptoms in the palms but all reported moderate compensatory hyperhydrosis located mainly in the trunk and lower extremities (two patients). SF-36 scores showed significant improvements in social functioning (p < 0.005), mental health (p < 0.049), and role-physical (p < 0.020) along with an increase in bodily pain (p < 0.012). CONCLUSION: Although TES resulted in some bodily pain and compensatory hyperhydrosis; these elements were outweighed by the improvement in palmar symptoms, social, mental, and role physical functioning, and overall quality of life.