Experiences in Thoracoscopic Sympathectomy for Axillary Hyperhidrosis and Osmidrosis

Abstract

THE ROLE OF thoracoscopic sympathectomy in treating palmar hyperhidrosis has been accepted worldwide since the introduction of video-assisted thoracic surgery in the early 1990s. More than 1400 thoracoscopic sympathectomies have been performed in our hospital since 1991. Axillary hyperhidrosis and osmidrosis cause considerable social and emotional handicaps. Since 1995, we have expanded our indications for performing thoracoscopic sympathectomy to treat this disorder. Large-scale treatment of axillary osmidrosis by sympathectomy is rare, and the proper extent of surgery is not well established. Different treatment approaches, including local application of deodorant,¹ excision or suction of apocrine glands,^2-4 and, more recently, local injection of botulinum toxin A,^5-7 have been used. From our experience in performing thoracoscopic sympathectomies, we applied this technique to patients with axillary hyperhidrosis and osmidrosis and worked to establish the proper extent of sympathectomy for this disorder.