Predicting changes in the distribution of sweating following thoracoscopic sympathectomy

Background Compensatory sweating is a common symptom following thoracic sympathectomy; however, the reported incidence of this complication varies greatly, and its severity has not been quantified. Methods in this study changes in the distribution of sweating following bilateral T2-3 thoracoscopic sympathectomy for hyperhidrosis were assessed in 42 patients. Sweat production in the palms, axillae, face, trunk and feet was assessed using a linear analogue scale. Results The operation was most successful in reducing sweat production in the palms, axillae and face (in descending order), The operation also reduced pedal sweat production in 12 of the 29 patients who suffered concomitant pedal hyperhidrosis. Compensatory truncal sweating occurred in 36 of the 42 patients: it was severe in ten, moderate in 16 and minimal in ten. Conclusion Patients should be warned about compensatory sweating before thoracic sympathectomy.