Abstract
BACKGROUND: Palmar hyperhidrosis (PH), characterized by excessive palm sweating, significantly impacts quality of life (QOL) in affected individuals, particularly young adults. This study aimed to evaluate the efficacy of video-assisted thoracoscopic sympathectomy (VATS) in improving symptoms and QOL among 816 patients with PH. METHODS: This retrospective study included 816 patients with PH, all of whom underwent VATS under general anaesthesia. One-year follow-up via phone surveys was used to assess symptom changes and side effects. Paired t tests were used to compare pre- and postoperative QOL scores, and linear regression was used to analyse the effects of various factors on QOL changes. RESULTS: The cohort consisted of 359 males and 457 females, with a mean age of 24.98 ± 6.47 years. All patients underwent VATS, with a 91% success rate, and the mean operative time was 53.2 ± 24.7 min. Postoperative complications included 43 cases of incision infections, 194 cases of chest pain, and 82 cases of pneumothorax; compensatory hyperhidrosis (CH) occurred in 53.80% of the T3 group and 43.74% of the T4 group after one month, with significant differences noted at the 24-month follow-up. Furthermore, the QOL scores significantly improved from 38.25 ± 3.61 preoperatively to 69.07 ± 3.48 at one year postoperatively (P < 0.05). CONCLUSIONS: VATS offers a reliable and effective treatment for severe PH, significantly enhancing patients' overall QOL. Future research should focus on long-term outcomes and the applicability of this treatment across diverse populations to further advance the clinical management of PH.