The Effect of Thoracoscopic Sympathectomy on Quality of Life and Symptom Management of Hyperhidrosis

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Abstract
Background Success with thoracoscopic sympathectomy (TS) for hyperhidrosis is 93% to 100%. We wished to determine if hyperhidrosis patients who do not undergo TS have decreased quality of life (QOL). Study design Data collection was retrospective, with telephone calls to hyperhidrosis patients who qualified for sympathectomy. Data collection included assessing sweating severity; overall QOL; social, professional, and cosmetic satisfaction; and comfort with daily activities. Results Between 1998 and 2005, 60 patients met the criteria for sympathectomy. Twenty-two patients who qualified but did not undergo operations (no TS) and 26 TS patients were contacted. Change in symptoms on a 10-point scale for hands was: no TS, −0.30 and TS, −6.25, p < 0.0001, and QOL, on a 1-to-5 scale, increased (no TS, 0.27 and TS, 1.65, p = 0.0003). Satisfaction was very good/excellent socially for 9 of 22 no TS patients and 23 of 26 TS patients (p = 0.002); professionally for 12 of 22 no TS patients and 23 of 26 TS patients (p = 0.021); and cosmetically for 10 of 22 no TS patients and 23 of 26 TS patients (p = 0.004). Patients were very satisfied with shaking hands (9 of 22 no TS patients and 24 of 26 TS patients, p = 0.0003); writing (9 of 11 no TS patients and 25 of 26 TS patients, p = 0.0001); eating (11 of 22 no TS patients and 25 of 25 TS patients, p = 0.0008). TS patients had more sweating on the abdomen (no TS patients, 0.0 and TS patients, 1.75, p = 0.0001), on the groin (no TS patients, 0.00 and TS patients, 2.9, p = 0.0009), and on the back (no TS patients, 0.48 and TS patients, 4.96, p = 0.0001). QOL was very good/excellent at followup for 13 of 22 no TS patients and 23 of 26 TS patients (p = 0.04). Conclusions TS controls palmar hyperhidrosis, and, despite compensatory sweating, patients having the procedure are very satisfied. Patients who did not have surgery have decreased satisfaction, comfort, and QOL, and increased symptoms.