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BioMed Research International
Volume 2013, Article ID 348017, 6 pages
Clinical Study

Bilateral Single-Port Sympathectomy: Long-Term Results and Quality of Life

1Division of Thoracic Surgery, Sant’Andrea Hospital, Faculty of Medicine and Psychology, University of Rome “Sapienza”, Via di Grottarossa 1035, 00189 Rome, Italy
2Division of Thoracic Surgery, “G. Mazzini” Hospital of Teramo, Faculty of Medicine and Surgery, University of L’Aquila, Piazza Italia 1, 64100 Teramo, Italy
3Division of Thoracic Surgery, Policlinico Umberto I Hospital, Faculty of Medicine and Pharmacy, University of Rome “Sapienza”, Viale del Policlinico 155, 00186 Rome, Italy
4Fondazione Eleonora Lorillard Spencer Cenci, Via Di Casal de’ Pazzi 10, 00156 Rome, Italy

Received 7 August 2013; Revised 16 October 2013; Accepted 21 October 2013

Academic Editor: Alejandro Comellas

Copyright © 2013 Mohsen Ibrahim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Object. Video-assisted thoracoscopic sympathectomy is a safe, effective, and minimally invasive procedure for primary hyperhidrosis. This study aims to evaluate long-term results and patients’ quality of life and investigate potential variables responsible for compensatory sweating after one-stage bilateral single-port thoracoscopic sympathectomy. Methods. Between 2005 and 2011, 260 consecutive bilateral thoracoscopic sympathectomies were performed in 130 patients for primary palmar and axillary hyperidrosis through one-port access. Residual pain, postoperative complications, recurrence of symptoms, heart rate adjustment, and quality of life were analyzed. Multivariate analysis was performed. Results. No operative mortality and conversion to open surgery were recorded. Mean operative time was 38 ± 5 minutes. Mean hospital stay was 1.1 ± 0.6 days. Eight patients (6%) had unilateral pneumothorax. Twenty-five cases (19%) were complicated by compensatory sweating. Winter and fall were identified as protective factors for compensatory sweating occurrence. Decreased heart rate was observed 1 year after surgery and permanently over the time. No recurrence during the follow-up period (31.5 months) was observed and 90% of patients showed improved quality of life. Conclusions. One-stage bilateral miniuniportal thoracoscopic sympathectomy is a valid and safe treatment for primary hyperhidrosis, achieving definitive and esthetic results, with excellent patients’ satisfaction. Compensatory sweating may potentially occur in a season-dependent manner.