There are two surgical methods to treat excessive sweating. One is the “classic” method and the other is the “endoscopic” method. The classic method is open surgery and it is done through large incisions. The second method is ETS (endoscopic thoracic sympathectomy). ETS is a procedure aiming to decrease sweating in certain areas that have excessive sweating.
The endoscopic method which has become widespread to treat excessive sweating is a closed operation. Both of the operations are equally effective. ETS surgery through clipping can be done in any season, as long as the patient is in good health.
Sympathectomy is a short closed surgical treatment option (thoracoscopic) with a very high success rate over 90-95%) for excessive sweating (hyperhidrosis), redness of the face and neck (blushing), and armpit bad odor (bromhidrosis).
However, side effects of this surgery are also present:
1.) Reactive (compensatory) sweating; In other parts of the body (back, abdomen, chest, butt, legs, etc.) may be sweating.
Treatment: First, a new endocrinology and dermatology examination should be done. If liver and kidney enzymes are normal on blood tests;
a. DRUG therapy (oxybutinin); Severe relief is achieved in 75% of patients with appropriate dose and follow-up.
b. If the drug treatment does not achieve sufficient success or shows side effects to the liver and kidneys, the last option is the closed thoracoscopic surgery as nerve joining (anastomoses) procedure. The effect begins to be felt in 2 months, and sits in 6 months. Success is also achieved in 75% of the patients.
2.) Horner syndrome (0.5%). It is usually unilateral and transient in 3-4 months.
3.) Dryness (9%). It appears in the hands. The need for moisturizing and adequate water intake are important.
4.) Gustatory sweating; perspiration of the face after meals.
5.) Pneumothorax (3.9%.) There is no need for drainage of the air around the lungs.
6.) Pain (there is a mild-to-moderate level of pain at the surgery sites at most patients). They are well controlled with pain relievers.
7.) Recurrence (3.7%; higher, especially in those with armpit perspiration). Sympathectomy can be performed again.
8.) 10% reduction in heart rate; *ECG heart rate should be greater than 55 beats/min. If it is slower, surgery should not be performed.
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