Outcome of Endoscopic Thoracic Sympathectomy Versus Radiofrequency Thympatholysis for Long Term Treatment of Patients with Hyperhidrosis
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- Category: Vol. 84, December 2016
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Outcome of Endoscopic Thoracic Sympathectomy Versus Radiofrequency Thympatholysis for Long Term Treatment of Patients with Hyperhidrosis, MOHAMED E. ERAKI and HASSAN A. SAAD
Abstract
Objectives: Hyperhidrosis is a disorder of excessive sweating in certain regions of the body, that cause emotional, psychological and educational troubles, the incidence of hyperhidrosis is between 0.6-1% of normal populations, it is usually treated by surgical sympathectomy, but now a days the use of radiofrequency thympatholysis has been used for successful management of hyperhidrosis [1]. In our study we compared the results of Endoscopic Thoracic Sympathectomy (ETS) with Radiofrequency Thympatholysis (RFT) in man-agement of primary hyperhidrosis for resistant cases to medical treatment.
Aim of the Work: The aim of this study is to evaluate the outcome of patients after Endoscopic Thoracic Sympathectomy (ETS) versus Radiofrequency Thympatholysis (RFT) for management of primary hyperhidrosis.
Patients and Methods: We had 60 patients complaining of bilateral hyperhidrosis in the palm and axilla; all patients with severe bilateral hyperhidrosis that had not responded to standard non-surgical treatment were included in our study.
Our analysis of 40 bilateral thoracoscopic sympathectomies and 20 patients had radiofrequency thympatholysis. Our study was done in General Surgery Department, Zagazig University Hospitals between May 2010 and June 2013.
Results: There were 60 patients who met our criteria, in which 40 patients were subjected to endoscopic thoracic sympathectomy, and 20 patients were subjected to radiofre-quency thympatholysis. In both groups there has no operative mortality, the success rate was 100% in patients with endo-scopic thoracic sympathectomy and was 97.5% in patients treated by radiofrequency thympatholysis. Compensatory sweating was seen in 6 patients with ETS (15%) and in one patient with RFT (5%). After 2 years follow-up there was no recurrence with ETS but with RF we had only one patient with recurrence on left side (2.5%).
Conclusion: From our study Radiofrequency Thympathol-ysis (RFT) is effective treatment for palmer and axillary hyperhidrosis that provide excellent immediate and long-term success with a low complication rate but with recurrence rate 2.5%. The procedure was done under local anesthesia and sedation with fewer side effects, safe and easy, less cost effective than endoscopic thoracic thympathectomy (ETS). RFT is effective as a retreatment for recurrences. ETS is also effective in the treatment of hyperhidrosis without recurrence and longer term effective treatment 100% success rate but cost effect, general anesthesia, with some non harmful com-plications.