A long-term evaluation of postoperative moist hands after R4/R4+5 sympathectomy for primary palmar hyperhidrosis

Thoracoscopic R4 sympathectomy has been recommended as a safe and effective surgical treatment procedure for primary palmar hyperhidrosis (PPH). However, approximately half of patients presented postoperative moist hands (PMH), and recurrence occurred individually. Therefore, more thorough long-term results should be evaluated. Between January 2005 and December 2014, 506 consecutive patients with palmar hyperhidrosis treated with either R4 or R4+5 were retrospectively reviewed and followed-up. A total of 451 patients (89.1%) completed the follow-up with an average follow-up time of 30.7±25.4 months. Palmar sweating completely ceased in 178 patients (39.5%), whereas 215 (47.7%) achieved greater than 50% improvement, 43 (9.5%) achieved 20-50% improvement. Fifteen individuals (3.3%) experienced recurrence. The frequency of individuals achieving 100% improvement was significantly higher in the group R4+5 than in the group R4 (60.9% 27.8%, respectively; P