A Prospective Randomized Comparative Study Comparing Clipping versus Thermal Ablation in Thoracoscopic Sympathectomy for Treatment of Hyperhidrosis

Abstract Background Hyperhidrosis can be defined as a pathologic condition characterized by excessive sweating beyond the body’s physiological needs to maintain its temperature within an adequate range. Aim of the Work The aim of this work is to Compare Clipping Versus Thermal Ablation in Thoracoscopic Sympathectomy according to the effectiveness, recurrence, and reversibility for Treatment of hyperhidrosis. Patients and Methods A randomized comparative prospective study was conducted in general and vascular surgery departments in Ain Shams University Hospital and Nasser institute hospital for research and treatment. The study included 20 patients diagnosed with primary hyperhidrosis either palmer and/or axillary. Results In our study the operative time in group A ranged from 55 – 81 minutes with mean time of 68.00 ± 8.78 minutes, While in group B, Time ranged from 45 – 70 minutes with mean time of 55.20 ± 8.59 minutes and that difference was statistically significant (P=0.004), despite that the difference between the operative time of the 2 groups was statistically significant, yet it was only about 12 minutes. The previous results indicated high success rate for both procedures and that there is no statistically significant difference between the two techniques regarding the efficacy, yet the clipping technique offered the theoretical reversibility. In our study no patients requested reversal of the effect even those who suffered from postoperative compensatory hyperhidrosis and all patients were satisfied with the result of the procedure. Conclusion Our study found that there is no statistically significant difference between the clipping and the cautery technique regarding operative time, rate of complication, compensatory hyperhidrosis, patient satisfaction and success rate, Yet the clipping technique has the potential theoritical reversibility in case of severe compensatory hyperhidrosis developed.