Quality of life after transthoracic endoscopic sympathectomy for upper limb hyperhidrosis

Objective: To assess the outcome after transthoracic endoscopic sympathectomy (TES) for upper limb hyperhidrosis. Design: Prospective cohort study. Setting: District general hospital. Subjects: Consecutive patients undergoing TES for upper limb hyperhidrosis over a fifteen month period. Interventions: One-stage bilateral TES. Main outcome measures: Change in quality of life as shown by the Short Form-36 health assessment questionnaire. Results: Sixteen patients (11 women and 5 men, median age 26 years) underwent operation without complications. At median follow-up of 6.2 months, symptomatic improvement was found in 26 of 32 limbs treated (82%). Truncal compensatory hyperhidrosis was reported by 13 patients but was severe in only three. There were significant improvements in social function (p = 0.01) and mental health (p = 0.025) as assessed by the SF-36. Conclusion: Despite a high incidence of compensatory hyperhidrosis, TES improved both the symptoms and overall quality of life in patients with upper limb hyperhidrosis.