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[Efficacy comparison of two methods of r3 sympathicotomy for palmar hyperhidrosis].

OBJECTIVE
To explore the necessity of interrupting nerve fibers of bypass thoracic sympathetic chain during edoscopic sympathicotomy (ETS) for palmar hyperhidrosis.


METHODS
Randomized controlled trial was performed for 200 patients of severe palmar hyperhidrosis from January 2009 to June 2011. They were randomly divided into 2 groups of R3 thoracic sympathctomy (R3) and R3 thoracic sympathicotomy plus bypass fiber resection at the same level (R3+) (n = 100 each). Clinical observations were recorded during a follow-up period of 3 years.


RESULTS
The curative rates of palmar and axillary hyperhidrosis were 100% for two groups. No statistically significant inter-group difference existed in left hand temperature increase after transecting thoracic sympathetic nerve (3.6 ± 1.4 °C vs 3.5 ± 1.3 °C), right hand increase (3.8 ± 1.3 °C vs 3.9 ± 1.1 °C), incidence of compensatory hyperhidrosis (40% vs 44%), recurrence rate (1% vs 2%) and postoperative satisfaction rate (92% vs 90%). But pain scores of R3 group was significantly lower than those of R3+ group (3.0 ± 1.9 vs 3.6 ± 1.9, P < 0.05).


CONCLUSION
Simple transaction of thoracic sympathetic chain during ETS is sufficient in the treatment of palmar hyperhidrosis. And it is unnecessary to transect bypass fibers.