Background: The most successful therapy for palmar hyperhidrosis (PH) has been established as endoscopic thoracic sympathectomy. In this research, sympathetic chain interruptions have been compared on the basis of whether the clipping or division by ablation method used to have an influence on the long-term results of patients who received thoracoscopic sympathectomy for primary PH.
Objective: evaluate the efficiency, safety, advantages and disadvantages of thoracoscopic sympathetic chain Division versus thoracoscopic sympathetic chain clipping in management of primary palmar hyperhidrosis.
Patients and methods: A prospective and randomized clinical trial was conducted from March 2021 to November 2021 in the AL-Azhar University Hospitals' Department of General Surgery (AL-Hussein and Sayed Galal) in Cairo, Egypt, involving twenty eligible consecutive people who suffer from primary palmar hyperhidrosis who were managed with bilateral, thoracoscopic sympathectomy by cutting the sympathetic chain (group A) or applying endo-clips (group B).
Results: In terms of hand dryness after 24 hours, there was a highly statistically significant difference between the groups investigated. In group A, all patients showed significant dryness of the hand on the spot or within the first 24 hours, while only 1 (10%) patient in group B showed complete dryness within the first 24 hours. In group B, 8 (80%) patients showed nearly dry hand and 1 (10%) patients showed wet hand on spot.
Conclusion: Endoscopic sympathetic block (ESB) is at least as effective as endoscopic thoracic sympathectomy in the therapy of primary palmar hyperhidrosis, but ESB has the advantage of reversibility.