Long-term results of 45 thoracoscopic sympathicotomies for primary hyperhidrosis in children.

Objective: Thoracoscopic sympathicotomy (TS) is successful in treatment of excessive hyperhidrosis of the upper limb after limited follow-up observation. The aim of the study was to assess for the first time long-term results of TS in children.

Methods: A total of 26 children (9 boys, 17 girls) aged 11 to 17 years with severe palmar or axillar hyperhidrosis underwent TS, and 19 patients were treated bilaterally. A total of 19 patients were observed after a median follow-up period of 16 years by questionnaire or clinical examination.

Results: Permanent relief from palmar hyperhidrosis was given in all examined patients. Twelve patients had compensatory and 12 patients gustatory sweating. Postoperatively, 1 subcutaneous emphysema and 1 temporary miosis and ptosis were noted. Eleven patients were fully satisfied with the result. Seven patients were only partially satisfied because of compensatory or gustatory sweating but would again undergo operation. One patient was not satisfied because of excessive compensatory sweating.

Conclusions: TS is a safe and efficient procedure even after long-term follow-up. Severe palmar hyperhidrosis often starts in childhood; thus, early surgical treatment can improve social development. Compensatory and gustatory sweating are the most frequent and enduring side effects and should be mentioned in preoperative patient and parent information.