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Ann Thorac Surg 2004;78:1052-1055
© 2004 The Society of Thoracic Surgeons

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Original article: general thoracic

Selective division of T3 rami communicantes (T3 ramicotomy) in the treatment of palmar hyperhidrosis

^a Respiratory Center, Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, People's Republic of China
^b Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Deajeon, Korea, People's Republic of China

Accepted for publication March 8, 2004.

^* Address reprint requests to Dr Lee, Department of Thoracic and Cardiovascular Surgery, Respiratory Center, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92, Dogok-dong, Kangnam-gu, Seoul, South Korea, People's Republic of China 135-720
dylee{at}yumc.yonsei.ac.kr

Presented at the Poster Session of the Fortieth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 26–28, 2004.

BACKGROUND: Compensatory sweating (CS) is the main cause of a patient's dissatisfaction after sympathetic surgery for palmar hyperhidrosis. Preservation of the sympathetic nerve trunk and limitations on the range of dissection are necessary to reduce CS.

METHODS: We compared 64 patients (31 male, 33 female) (group 1) who underwent a T2 sympathicotomy between July 1998 and February 1999 and 83 patients (58 male, 25 female) (group 2) who underwent a T3 ramicotomy between August 2000 and December 2002.

RESULTS: In group 1, 60 patients (93.8%) exhibited a decreased sweating on both hands, but 4 patients (6.2%) exhibited a persistent sweating on both hands. For group 2, 58 patients (69.9%) experienced a decreased sweating on both hands, 15 patients (18.1%) experienced a persistent sweating on both hands, and 10 patients (12.0%) experienced a persistent sweating on one hand. The grade of CS in group 2 was significantly lower than in group 1 (p < 0.001) and, notably, the rate of embarrassing and disabling CS in group 2 (15.5% [9 out of 58]) was significantly lower than in group 1 (43.3% [26 out of 60], p value < 0.001). The rate of satisfaction was 78.1% (50 out of 64) for group 1 and 68.6% (57 out of 83) for group 2 with no significant statistical difference indicated (p = 0.202).

CONCLUSIONS: The incidence of sweating postoperatively was relatively high in the T3 ramicotomy group, although the T3 surgery did result in a lower incidence of CS when compared with a T2 sympathicotomy.

This article has been cited by other articles:

				M. J. Krasna Thoracoscopic Sympathectomy: A Standardized Approach to Therapy for Hyperhidrosis Ann. Thorac. Surg., February 1, 2008; 85(2): S764 - S767. [Abstract] [Full Text] [PDF]

				J. Schmidt, F. G. Bechara, P. Altmeyer, and H. Zirngibl Endoscopic Thoracic Sympathectomy for Severe Hyperhidrosis: Impact of Restrictive Denervation on Compensatory Sweating. Ann. Thorac. Surg., March 1, 2006; 81(3): 1048 - 1055. [Abstract] [Full Text] [PDF]