Author: Rafael Reisfeld

Recurrence after sympathectomy performed for Palmar or Plantar hyperhidrosis

As with any other surgical procedure the patient and the surgeon can expect a chance of symptoms recurrence. When endoscopic thoracic sympathectomy or lumbar sympathectomy is performed the surgeon offer a mechanical solution to a physiological-genetic problem. This can lead to a small rate of recurrence. The exact reason for the recurrence is not yet defined. The recurrence rate after the operation is between 1-1.5%. If the recurrence happens after a long period of time (more than 1 year), it is thought to be due to redirecting of the nerve signals through different pathways. If this happens the patient should discuss the matter with his/her surgeon.

On the other hand if the recurrence happens with in a short time then a technical mistake should be considered as the cause. Again this should be discussed with the surgeon. Sometimes there is a mild return of sweating immediately after the operation but if it mild and is not as excessive as before the operation then no further action should be taken

Another explanation for a recurrence is the fact that very small fibers belonging to the sympathetic nervous system are branching outside of the area that was clamped or resected. There is no way to identify those small fibers because in the human body those fibers (either in lumbar or thoracic) can be very hard to identify due to size and location.

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