Clipping of T2 Sympathetic Chain Block for Essential Hyperhidrosis

Lee, Doo Yun; Yoon, Yong Han; Paik, Hyo Chae; Shin, Hwa Gyun; Lee, Sung Soo; Kang, Jung Sin

Abstract

BACKGROUND: A definitive cure for an essential hyperhidrosis can be obtained by an upper thoracic sympathectomy. However, this is offset by the occurrence of a compensatory hyper hidrosis as a side effect and it is irreversible. We performed a thoracoscopic sympathetic chain block using an endoscopic clip in order to avoid the compensatory hyperhidrosis. MATERIAL AND METHOD: From Aug. 1998 to Nov. 1998, 42 cases of thoracoscopic clipping of the T2 sympathetic chain were performed. The sympathetic chain was clipped using an endoscopic clip instead of cutting. RESULT: Bilateral procedure took less than 40 minutes and occasionally necessitated one night in the hospital. There were no mortality nor life- threatening complications. Horners syndrome occurred in two cases. At the end of postoperative follow-up(median 3 months), 95.0% of the patients were satisfied with the results. Compensatory sweating occurred in 31 cases(77.5%) where nine of those cases were classified as either embarrassing(6 cases-15.0%) or disabling(3 cases-7.5%).
CONCLUSION
Endoscopic thoracic T2 sympathetic chain block using endoscopic clipping is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis and the results were similar to those underwent T2 sympathicotomy. We recommend that patients receive endoscopic sympathetic chain block in summer.