Estudio sobre la aplicación de simpatectomía toracoscópica bilateral extendida en el Servicio de Cirugía General del Hospital Enrique Garcés

Objective: We evaluated the results, complications and degree of satisfaction of patients with primary palmar hyperhidrosis treated with bilateral extended T3 videothoracoscopic sympathectomy at the General Surgery and Thoracic Surgery Service of the Enrique Garcés Hospital, belonging to the Ministry of Public Health, during the period from January 2009 to May 2012. Material and methods: This was a prospective, operative intervention study that included 35 thoracic sympathectomies, using a questionnaire for the evaluation of postoperative quality of life and the analysis of the patients' medical records. All patients treated surgically were included, forming a universe of 35 patients (18 men and 17 women), aged between 16 and 39 years, diagnosed with primary palmar and axillary hyperhidrosis, in some cases severe. All patients underwent surgery under general anesthesia and bilateral extended T3 videothoracoscopic sympathectomy. Follow-up was carried out by means of a questionnaire related to quality of life and degree of preoperative and postoperative satisfaction. Frequency analysis and description of the data obtained on surgical technique, quality of life and postoperative complications were performed. Results: The percentage of therapeutic success achieved was 94.2%. No complications derived from the procedure were reported during the trans-surgical phase; in the post-surgical phase, the rate of complications was 11.4%, with 1 case of pneumothorax, 1 case of hemothorax and 2 cases of recurrence in this group. In the postoperative follow-up, 20% of the patients (7 cases) reported mild chest pain and 5.8% (2 cases) moderate chest pain. As for compensatory sweating, 13 patients (37.1%) presented mild compensatory sweating and 4 cases (11.4%) moderate compensatory sweating. Most patients, after the procedure, reported an improvement in quality of life (94.2%, n=33), while in 2 cases (5.8%) the symptomatology prior to surgery was maintained. No aggravation of symptoms was reported. Conclusions: Videothoracoscopic sympathectomy proved to be an effective method to treat primary palmar and axillary hyperhidrosis, with low morbidity rates. Despite the presence of compensatory sweating, the procedure showed a high rate of satisfaction and improvement in patients' quality of life.