Journal of Minimally Invasive Surgical Sciences

Published by: Kowsar

Comparison Between R2-R4 and R3-R5 Sympathicotomy for Primary Hyperhidrosis

Hassan Ali Mohebbi 1 , 2 , Shaban Mehrvarz 1 , Saba Emami 2 , Shahram Manoochehry 1 , * and Mahdieh Mohebbi 2
Authors Information
1 Surgical Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
2 Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
Article information
  • Journal of Minimally Invasive Surgical Sciences: November 01, 2014, 3 (4); e20543
  • Published Online: September 20, 2014
  • Article Type: Research Article
  • Received: May 21, 2014
  • Revised: July 9, 2014
  • Accepted: July 15, 2014

To Cite: Mohebbi H A, Mehrvarz S, Emami S, Manoochehry S, Mohebbi M. Comparison Between R2-R4 and R3-R5 Sympathicotomy for Primary Hyperhidrosis, J Minim Invasive Surg Sci. 2014 ; 3(4):e20543.

Copyright © 2014, Minimally Invasive Surgery Research Center and Mediterranean & Middle Eastern Endoscopic Surgery Association. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Method
4. Results
5. Discussion
  • 1. Kuijpers M, Klinkenberg TJ, Bouma W, DeJongste MJ, Mariani MA. Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach. J Cardiothorac Surg. 2013; 8: 216[DOI][PubMed]
  • 2. Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011; 91(5): 1642-8[DOI][PubMed]
  • 3. Higashimoto I, Yoshiura K, Hirakawa N, Higashimoto K, Soejima H, Totoki T, et al. Primary palmar hyperhidrosis locus maps to 14q11.2-q13. Am J Med Genet A. 2006; 140(6): 567-72[DOI][PubMed]
  • 4. Ro KM, Cantor RM, Lange KL, Ahn SS. Palmar hyperhidrosis: evidence of genetic transmission. J Vasc Surg. 2002; 35(2): 382-6[PubMed]
  • 5. Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg. 1977; 186(1): 34-41[PubMed]
  • 6. Strutton DR, Kowalski JW, Glaser DA, Stang PE. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol. 2004; 51(2): 241-8[DOI][PubMed]
  • 7. Tu YR, Li X, Lin M, Lai FC, Li YP, Chen JF, et al. Epidemiological survey of primary palmar hyperhidrosis in adolescent in Fuzhou of People's Republic of China. Eur J Cardiothorac Surg. 2007; 31(4): 737-9[DOI][PubMed]
  • 8. Bechara FG, Gambichler T, Bader A, Sand M, Altmeyer P, Hoffmann K. Assessment of quality of life in patients with primary axillary hyperhidrosis before and after suction-curettage. J Am Acad Dermatol. 2007; 57(2): 207-12[DOI][PubMed]
  • 9. Rieger R, Pedevilla S. Retroperitoneoscopic lumbar sympathectomy for the treatment of plantar hyperhidrosis: technique and preliminary findings. Surg Endosc. 2007; 21(1): 129-35[DOI][PubMed]
  • 10. Solish N, Bertucci V, Dansereau A, Hong HC, Lynde C, Lupin M, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg. 2007; 33(8): 908-23[DOI][PubMed]
  • 11. Ahn SS, Wieslander CK, Ro KM. Current developments in thoracoscopic sympathectomy. Ann Vasc Surg. 2000; 14(4): 415-20[PubMed]
  • 12. de Campos JR, Kauffman P, Werebe Ede C, Andrade Filho LO, Kusniek S, Wolosker N, et al. Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg. 2003; 76(3): 886-91[PubMed]
  • 13. Liu Y, Yang J, Liu J, Yang F, Jiang G, Li J, et al. Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy. Eur J Cardiothorac Surg. 2009; 35(3): 398-402[DOI][PubMed]
  • 14. Baumgartner FJ. Surgical approaches and techniques in the management of severe hyperhidrosis. Thorac Surg Clin. 2008; 18(2): 167-81[DOI][PubMed]
  • 15. Dewey TM, Herbert MA, Hill SL, Prince SL, Mack MJ. One-year follow-up after thoracoscopic sympathectomy for hyperhidrosis: outcomes and consequences. Ann Thorac Surg. 2006; 81(4): 1227-32[DOI][PubMed]
  • 16. Mohebbi HA, Mehrvarz S, Manoochehry S. Thoracoscopic Sympathicotomy vs Sympathectomy in Primary Hyperhidrosis. Trauma Mon. 2012; 17(2): 291-5[DOI][PubMed]
  • 17. Hwang JJ, Kim do H, Hong YJ, Lee DY. A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis. Surg Today. 2013; 43(4): 397-402[DOI][PubMed]
  • 18. Walles T, Somuncuoglu G, Steger V, Veit S, Friedel G. Long-term efficiency of endoscopic thoracic sympathicotomy: survey 10 years after surgery. Interact Cardiovasc Thorac Surg. 2009; 8(1): 54-7[DOI][PubMed]
  • 19. Yuncu G, Turk F, Ozturk G, Atinkaya C. Comparison of only T3 and T3-T4 sympathectomy for axillary hyperhidrosis regarding treatment effect and compensatory sweating. Interact Cardiovasc Thorac Surg. 2013; 17(2): 263-7[DOI][PubMed]
  • 20. Chou SH, Kao EL, Lin CC, Chang YT, Huang MF. The importance of classification in sympathetic surgery and a proposed mechanism for compensatory hyperhidrosis: experience with 464 cases. Surg Endosc. 2006; 20(11): 1749-53[DOI][PubMed]
  • 21. Drott C. Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm. Clin Auton Res. 2003; 13 Suppl 1-30[DOI][PubMed]
  • 22. Zacherl J, Imhof M, Huber ER, Plas EG, Herbst F, Jakesz R, et al. Video assistance reduces complication rate of thoracoscopic sympathicotomy for hyperhidrosis. Ann Thorac Surg. 1999; 68(4): 1177-81[PubMed]
  • 23. Toolabi KRA, Salimi J, Rabani A, Meisami A. Thoracoscopic sympathectomy of T2 and T3 ganglions for palmar hyperhydrosis. Tehran Univ Med J. 2008; 65: 37-43
  • 24. Zacherl J, Huber ER, Imhof M, Plas EG, Herbst F, Fugger R. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Eur J Surg Suppl. 1998; (580): 43-6[PubMed]
  • 25. Prasad A, Ali M, Kaul S. Endoscopic thoracic sympathectomy for primary palmar hyperidrosis. Surg Endosc. 2010; 24(8): 1952-7[DOI][PubMed]
  • 26. Schmidt J, Bechara FG, Altmeyer P, Zirngibl H. Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating. Ann Thorac Surg. 2006; 81(3): 1048-55[DOI][PubMed]
  • 27. Oncel M, Sadi Sunam G, Erdem E, Dereli Y, Tezcan B, Gurol Akyol K. Bilateral thoracoscopic sympathectomy for primary hyperhydrosis: a review of 335 cases. Cardiovasc J Afr. 2013; 24(4): 137-40[DOI][PubMed]
  • 28. Kim JB, Park CK, Kum DY. The effect of thoracoscopic sympathicotomy at the fourth rib (r4) for the treatment of palmar and axillary hyperhidrosis. Korean J Thorac Cardiovasc Surg. 2011; 44(2): 154-8[DOI][PubMed]
  • 29. Scognamillo F, Serventi F, Attene F, Torre C, Paliogiannis P, Pala C, et al. T2-T4 sympathectomy versus T3-T4 sympathicotomy for palmar and axillary hyperhidrosis. Clin Auton Res. 2011; 21(2): 97-102[DOI][PubMed]
  • 30. Kim WO, Kil HK, Yoon KB, Yoon DM, Lee JS. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg. 2010; 199(2): 166-9[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments