Background: Excessive palmar and axillary sweating are the most problematic symptoms in patients with hyperhidrosis. Patients who undergo thoracoscopic sympathectomy for this condition may experience post-op compensatory sweating. Even though Taiwan ranks high in the number of thoracoscopic
sympathectomies done annually, there has not been any report on postoperative changes in quality of life as well as an explanation for the rapid decline in the number of patients with
hyperhidrosis who choose surgical management. This research will explore and discuss the factors that influence patients with upper limb hyperhidrosis
undergoing thoracoscopic sympathectomy and the resulting life quality changes.
Methods: A retrospective study is performed on 1673 hyperhidrosis patients who were seen in a medical clinic in the central region of Taiwan from the year of 2000 to 2006. A structured questionnaire was used to collect data, which included the changes in the patient?s quality of life and patient?s basic information. In addition to analyzing the data objectively, a logistic regression analysis was also
performed to determine the significant factors that influence the patient?s decision to undergo thoracoscopic sympathectomy.
Results: The patients with hyperhidrosis who underwent thoracoscopic
sympathectomy have much poor life quality . In addition, there are eight factors that are significant in influencing the patient?s decision in receiving a
thoracoscopic sympathectomy (p<0.05). These factors include the effect of pre- operative symptoms on the patient?s quality of life, financial burden of receiving the surgery, the level of family support, age,the effectiveness of previous non- surgical treatments, the patient?s job status at the time of seeking medical help, the physician?s opinion, and the considerations on post-operative compensatory sweating. Our research also shows that 90% of the patients who has had
thoracoscopic sympathectomy have symptoms of compensatory sweating, 72% of which have severe symptoms.
Conclusions: Even though sympathectomy has actually improved the life qualities of patients with hyperhidrosis, to improve patients? will of having sympathectomy as the treatment for hyperhidrosis, emphasis should be placed on physician?s professional attitude, detailed explanations of the surgical procedures, and the reduction of incidence of post-operative compensatory sweating and its severity.
