LAUSR

Palmar hyperhidrosis (PH) refers to excessive sweating that affects patients’ quality of life, resulting in social and work impairment and emotional distress. Thoracic sympathectomy (TS) is the best surgery option for palmar hyperhidrosis; however, there was no agreement for the choice of optimal surgery level. The aim of this study was to systematically compare postoperative effect between thoracoscopic T3 and T4 thoracic sympathectomy for palmar hyperhidrosis and to help clinical decision. Studies comparing T3 versus T4 thoracic sympathectomy for palmar hyperhidrosis were searched overall the database and a meta-analysis was performed. After searching, 12 articles were selected and a total of 1192 patients with palmar hyperhidrosis, of whom 567 patients underwent T3 thoracic sympathectomy and 625 patients underwent T4 thoracic sympathectomy. After analysis, we found that T4 thoracic sympathectomy had fewer side effects than T3 thoracic sympathectomy, so T4 may be the optimal level for thoracic sympathectomy in palmar hyperhidrosis patients.