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Ann Thorac Surg 2003;76:886-891
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Quality of life, before and after thoracic sympathectomy: report on 378 operated patients

^a Division of Thoracic Surgery Division of Vascular Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil

Accepted for publication May 14, 2003.

^* Address reprint requests to Dr Milanez de Campos, Rua Almirante Soares Dutra n. 520, São Paulo, CEP: 05654.000, Brazil.
e-mail: jribas{at}usp.br

BACKGROUND: Thoracic sympathectomy is indicated to treat primary hyperhidrosis. The objective is to analyze the results and complications of thoracic sympathectomy and propose a questionnaire to assess the quality of life of patients.

METHODS: Between October 1995 and March 2002, 378 patients were evaluated. Sixty-two percent were female, with a mean age of 26.8 years old (range 9 to 70 years old). There were 57.4% patients with palmar-plantar hyperhidrosis; 25% with palmar, plantar, and axillary hyperhidrosis; 15.7% with pure axillary hyperhidrosis; and 6.5% with craniofacial hyperhidrosis. General anesthesia was used in 97.3%, epidural with sedation in 2.7%. The sympathetic chain was resected in 12.5%, thermal ablation with the electrical scalpel was performed in 66.3%, and with the harmonic scalpel in 21.2% of the patients.

RESULTS: Successful sympathectomies were performed in 90.3% of the patients; the follow-up was from 1 to 60 months (mean 12.4 ± 8.3 months). The recurrence rates were 8.2% for palmar hyperhidrosis, 13.7% for pure axillary hyperhidrosis, 27.5% of which were reoperated successfully. Improvement of the plantar hyperhidrosis was also registered in 58%. Horner's syndrome was reported in 1% with regression in half of them after 30 days. No mortality or serious complications were observed, nor the need to convert to thoracotomy. Of the total number of patients, 93.4% answered the quality of life questionnaire, 86.4% of whom noted improvement after the procedure.

CONCLUSIONS: Thoracic sympathectomy is a simple, effective, safe method for the treatment of hyperhidrosis, resulting in an improved quality of life for patients. The questionnaire documents this change.

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