Effect of Uniportal Thoracoscope Right R3 Combined with Left R4 Sympathectomy in Treatment of Primary Palmar Hyperhidrosis

CUI Dong; CHEN Maolin; ZHANG Weidong; LUAN Jiaqiang; FENG Yu; HOU Manman; CAI Zuxun; QIAN Rulin

doi:10.3969/j.issn.1004-437X.2025.03.005

Abstract：Objective To observe the efficacy and safety of uniportal thoracoscope right R3 combined with left R4 sympathectomy in treatment of primary palmar hyperhidrosis.Methods From October 2021 to June 2023,50 patients with moderate or severe primary palmar hyperhidrosis underwent uniportal thoracoscope sympathectomy in the Department of Thoracic Surgery of Henan Chest Hospital were enrolled in the study and randomly assigned into observation group and control group,with 25 cases in each group.Observation group recieved right R3 combined with left R4 sympathectomy and a control group recieved bilateral R3 sympathectomy.The clinical indicators and postoperative recovery were compared between the tow groups.Results All procedures were carried out successfully without severe morbidity or mortality.There were 10 cases of left hand with mild damp in the observation group,2 cases in the observation group and 1 case in the control group.The damp rate of left hand in the control group was lower than that in the observation group(P＜0.05).Compensatory hyperhidrosis occurred in 14 cases(56.0％)and 18 cases(72.0％)respectively in observation group and control group.There was no significant difference in the incidence of mild compensatory hyperhidrosis between the two groups.The incidence of moderate and severe compensatory hyperhidrosis in the observation group was lower than that in the control group(P＜0.05).Conclusion Uniportal thoracoscope right R3 combined with left R4 sympathectomy is effective in treatment of primary palmar hyperhidrosis,and reduces the probability of moderate and severe compensatory hyperhidrosis,which is safe and feasible and worthy of further exploration and promotion.