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Reoperation for Essential Hyperhidrosis

Department of Thoracic & Cardiovascular Surgery Yongdong Severance Hospital Seoul, Korea (South)

For reprint information contact: Lee Doo Yun, MD Tel: 82 2 3497 3380 Fax: 82 2 3461 8282 email: dylee{at}yumc.yonsei.ac.kr Department of Thoracic & Cardiovascular Surgery, Respiratory Center, Yongdong Severance Hospital, Yonsei College of Medicine, 146-92 Dokuk-dong, Kangnam-gu, Seoul, Korea.

Palmar hyperhidrosis has a recurrence rate of 0% to 5% after thoracic sympathectomy. From January 1992 to October 1997, thoracic sympathectomy was performed by video-assisted thoracoscopic surgery for hyperhidrosis in 490 patients of whom 5 (2 male and 3 female with a mean age of 20 years) experienced recurrent hyperhidrosis in the early (< 7 days) or late (up to 6 months) postoperative period. All patients had moderate to severe pleural adhesions in the previous sympathectomy sites but no operative complications or crossover to thoracotomy occurred. Surgery resulted in satisfactory outcomes showing that video-assisted thoracoscopic sympathectomy was effective in treating recurrent hyperhidrosis. Prevention of recurrence requires the identification and resection of the second thoracic sympathetic ganglion as well as the Kuntz fibers.