Background: Different techniques of video-assisted thoracic sympathectomy have been suggested to
control the symptoms of axillary hyperhidrosis. We compared the results using two different levels
of ganglion resection for treating axillary hyperhidrosis: T3/T4 vs. T4.
Materials and Methods: From a group of 1119 patients operated on between July 2000 and January
2005, 276 patients with axillary hyperhidrosis were studied. The mean age was 26 (range, 13–54
years) and 61.6% were female. Of these patients, 216 (78.3%) were treated with thermal ablation
of T3/T4 and 60 (21.7%) with thermal ablation of T4 alone. The procedures were bilateral and simultaneous,
using two 5.5-mm trocars and 30-degree optical systems, under general anesthesia in
all cases.
Results: There was no mortality and no important postoperative complications or need to convert
to thoracotomy in either group. The mean follow-up in the T4 group was 11 months (range,
2–23 months) and in the T3/T4 group mean follow-up was 24 months (range, 13–54 months). The
immediate therapeutic success rate was 100% in both groups. There were recurrences in 7 (2.5%)
patients, all from the T3/T4 group. The satisfaction rate was higher and more stable in the T4 group
and compensatory sweating was lower in the T4 group.
Conclusion: Both techniques proved effective for controlling the axillary symptoms. Group T4
presented a higher satisfaction rate, lower recurrence rate, and lower severity of compensatory
sweating.
