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COMPARISON OF LONG TERM SURGICAL OUTCOMES BETWEEN T3 AND T4 LEVEL OF THORACOSCOPIC SYMPATHECTOMY IN PATIENTS WITH PRIMARY PALMAR HYPERHIDROSIS

Isariya Jongekkasit, MD, Pornpeera Jitpratoom, MD, Angkoon Anuwong, MD, Soravith Vijitpornkul, MD, Warin Wachirapunyaukul, MD. Police General Hospital

INTRODUCTION:  Primary palmar hyperhidrosis (PH) is a pathological condition of over perspiration caused by body produces an excessive amount of sweat. This disorder affects to decrease quality of life of patients.  Thoracoscopic sympathectomy is minimally invasive and an effective procedure to treat hyperhidrosis. Different of level of sympathectomy has been debate for the best outcomes. Many researchers studied about short term outcomes but no empirical research evidences long term outcomes of thoracoscopic sympathectomy in Thailand.  This study purposed to evaluate and compare the long term clinical outcomes between patients who underwent T3 and T4 thoracoscopic sympathectomy for PH with particular attention to patient satisfaction and quality of life.

METHODS AND PROCEDURES:  Sixty patients with PH underwent thoracoscopic sympathectomy. Patients were divided into two groups by the level of thoracoscopic sympathectomy as T3 group and T4 group.  They were investigated the improvement of sweating, compensatory sweating, satisfaction and quality of life. The long-term investigation was designed to examine clinical outcomes at before surgery, six months after surgery, 1 year after surgery, 3 years after surgery, and last follow up days were compared within group and between of T3 and T4 group. They were subjected to telephone interview using multiple questionnaires to investigate surgery outcomes, degree of satisfaction, and quality of life improvement.

RESULTS:  Sixty patients responded to the telephone interview. Patients demographic data and also recurrence rate of PH between T3 and T4 group was not significant different (p=0.353). Both groups improved severity of sweating without any statistical significant. But the T4 thoracoscopic sympathectomy led to significantly lower incidence of compensatory hyperhidrosis when compared with T3 group at back and trunk sites. The T4 group had higher overall satisfaction than T3 group with was not significantly different. Long term result are followedafter3 years.

CONCLUSIONS: There was no difference in decreasing severity of sweating between T3 and T4 level of thoracoscopic sympathectomy. Both group equally archived patient satisfaction. But the T4 level of thoracoscopic significantly had lower severity of CH and better quality of life in long term period.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87233

Program Number: P670

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

44

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