ArticleAnnals of surgery2007
Treatment of palmar hyperhidrosis: T(4) level compared with T(3) and T(2).
Article in Annals of surgery, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- T2-sparing vs T2-including sympathectomy for hyperhidrosis: a meta-analysis on compensatory sweating.Journal of cardiothoracic surgery · 2026Pooled it
- Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: an updated systematic review.Surgical endoscopy · 2017Pooled it
- A systematic review and meta-analysis of T2, T3 or T4, to evaluate the best denervation level for palmar hyperhidrosis.Scientific reports · 2017Pooled it
- Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis.Clinics (Sao Paulo, Brazil) · 2015Pooled it
- Effect of lowering or restricting sympathectomy levels on compensatory sweating.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2014Trial
- Observational
- Sympathetic signals beneath the surface: fresh insights from skin and muscle.Frontiers in neuroscience · 2025Review
- Article
- Changes in electrodermal activity following sympathicotomy in hyperhidrosis patients.Frontiers in surgery · 2024Article
- Anatomical variation of sympathetic ganglia in R4+R5 sympathicotomy for primary palmar axillary hyperhidrosis.Journal of thoracic disease · 2023Article
- Anatomical variations of the thoracic sympathetic ganglions and their effects on sympathicotomy for primary palmar hyperhidrosis.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Article
- Is there any relationship between quality of life and the level of sympathectomy in primary palmar hyperhidrosis? Single-center experience.General thoracic and cardiovascular surgery · 2020Article
- Article
- Comparison of the Long-Term Results of R3 and R4 Sympathicotomy for Palmar Hyperhidrosis.The Korean journal of thoracic and cardiovascular surgery · 2017Article
- Sympathotomy for palmar hyperhidrosis: the cutting versus clamping methods.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2015Article
- Semi-Fowler vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis.Journal of thoracic disease · 2015Article
- Is clipping the preferable technique to perform sympathicotomy? A retrospective study and review of the literature.Langenbeck's archives of surgery · 2015Review
- Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis.Journal of anesthesia · 2014Article
- Reply to: doi:10.1007/s00464-013-2987-3: re: optimization of sympathectomy to treat palmar hyperhidrosis.Surgical endoscopy · 2013Article
- A comparison between two types of limited sympathetic surgery for palmar hyperhidrosis.Surgery today · 2013Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to compare the outcomes of 3 different levels of sympathectomy. SUMMARY BACKGROUND DATA: Most surgeons still perform T(2) or T(2-3) sympathectomy for palmar hyperhidrosis, but both these treatments can cause severe side effects. Some recent articles have advocated T(4) sympathectomy and obtained satisfactory results.
methodsBetween January 2000 and August 2004, 234 records of patients treated for palmar hyperhidrosis were retrospectively reviewed. Of them, 86 patients were treated with endoscopic thoracic sympathectomy of T(2) (ETS(2)), 78 patients with ETS(3), and 70 patients with ETS(4). Follow-up data were collected using a telephone questionnaire with a scoring system. Multiple linear regressions were used to model markers for degree of satisfaction and severity of compensatory sweating (CS), including descriptive data, level of sympathectomy, clinical outcomes, and postoperative complications.
resultsMean follow-up was 47.1 +/- 17.2 months. All 3 levels of sympathectomy could have achieved comparable improvement of palmar hyperhidrosis (P = 0.162). However, 88.5% of the patients noticed CS. Patients with ETS(4) presented the lowest incidence of CS (P = 0.030), had the least severity of CS (beta = -1.537, P = 0.002), and felt the least palmar overdryness (P < 0.001). None expressed regret for the procedure in the ETS(4) group (P = 0.022). Being obese did not increase the incidence of CS, but the severity of CS was directly related to body mass index (beta = 0.917, P < 0.001). The patients would be more satisfied if the severity of CS was minimal (beta = -0.185, P = 0.002). The degree of satisfaction may decrease with time (beta = -0.025, P = 0.003) and was lower when their palms were overdry (beta = -1.463, P < 0.001).
conclusionsDifferent from the current procedure of T(2) or T(3) sympathectomy for palmar hyperhidrosis, T(4) sympathectomy would be a better and more effective procedure with minimal long-term complications.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.