ArticleJournal of cardiothoracic surgery2025
Compensatory hyperhidrosis following endoscopic thoracic sympathectomy: a 5-year follow-up study of risk factors and symptom progression.
Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Prediction of compensatory hyperhidrosis severity after endoscopic thoracic sympathectomy in primary hyperhidrosis patients based on rough set analysis.Journal of thoracic disease · 2026Article
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Abstract
backgroundCompensatory hyperhidrosis (CH) is a common complication after endoscopic thoracic sympathectomy (ETS) for hyperhidrosis. Despite its prevalence, long-term data on CH progression and associated risk factors are scarce. This study aimed to evaluate the risk factors and progression of CH during a 5-year follow-up period.
methodsThis study retrospectively analyzed 138 patients with primary palmar hyperhidrosis (PPH) who underwent endoscopic thoracic sympathectomy between January 2014 and December 2019. All patients received bilateral single-port thoracoscopic sympathectomy and were followed up at 1, 3, and 5 years postoperatively. The severity of postoperative sweating was assessed using the Hyperhidrosis Disease Severity Scale (HDSS). Univariate and multivariate logistic regression analyses were performed to identify risk factors associated with the development and progression of CH.
resultsA total of 138 patients were included in the study, with 78.9% reporting the occurrence of CH after surgery and 23.8% of them experiencing severe CH. HDSS scores gradually increased over the 5-year postoperative period, indicating symptom worsening. Further analysis revealed that bilateral R4-level sympathectomy significantly increased the risk of CH progression (OR = 4.28, 95% CI: 1.27-15.60, P = 0.021) while having three or more affected areas was identified as a protective factor (OR = 0.19, 95% CI: 0.05-0.63, P = 0.008).
conclusionThis study found that compensatory hyperhidrosis is relatively common in patients undergoing ETS, and symptoms may progressively worsen over time. The level of sympathetic nerve resection and the number of affected areas are key predictive factors for symptom progression.
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