Endoscopic lumbar sympathectomy for plantar hyperhidrosis

Background: The aim of this study was to evaluate the results of endoscopic lumbar sympathectomy for plantar hyperhidrosis. Methods: A total of 178 endoscopic resections of the lower sympathetic lumbar trunk were carried out in 90 patients (59 men, 31 women) with severe plantar hyperhidrosis. The clinical results, including morbidity and satisfaction rates, were evaluated. Follow-up examination was carried out for all patients after a mean follow-up of 24 (range 3–45) months. Results: All procedures were carried out endoscopically. There were no deaths and only three patients had a postoperative complication. All patients had evidence of postoperative sympathetic denervation of the feet. In 87 patients (97 per cent) hyperhidrosis was eliminated, but in three (3 per cent) it recurred. Compensatory sweating occurred in 40 patients (44 per cent), postsympathectomy neuralgia in 38 (42 per cent) and one man suffered temporary loss of ejaculation. A total of 86 patients (96 per cent) were very, or partly, satisfied with the result, and 83 (92 per cent) would have the procedure repeated if required. Conclusion: Endoscopic lumbar sympathectomy was a safe and effective option for patients with severe plantar hyperhidrosis. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.