الفهرس 
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Abstract
SUMMARY
This prospective randomized comparative study was carried on fifty patients diagnosed to have primary palmar hyperhidrosis, twenty-five (25) patients was treated by using two ports thoracoscopic sympathectomy while the patient was in supine position and twenty-five (25) patients by using three ports thoracoscopic sympathectomy while the patient was in lateral position.
This study was carried out at the surgical department of Beni-Suef University hospital and Military hospitals from January 2021 with a follow up period for six months.
This study was carried on fifty patients diagnosed to have primary palmar hyperhidrosis, divided into two groups. group one, included twenty five(25)patients were treated by using two ports thoracoscopic sympathectomy while the patient was in supine position and group two, included twenty five(25)patients by using three ports thoracoscopic sympathectomy while the patient was in lateral position.
This studyhas showed that using two ports thoracoscopic sympathectomy while the patient was in supine position is a highly effective technique and take less time with fewer side effects for performing ETS.
This study proved that Supine position gives adequate visualization of the first three sympathetic ganglia and effectively reduces the operative time without increasing the risk of complications, The operation time differed among the two groups as in group A ( by using two ports thoracoscopic sympathectomy while the patient was in supine position) the median operation time was 15 minutes (range, 10-20 minutes) lower than group B(by using three ports thoracoscopic sympathectomy while the patient was in lateral position) in which the median operation time was 40 minutes (range, 35-45 minutes).
In this study all operations were successfully performed with 16% (n=8) overall complications rate. The percentage of patients developing complications in group A 12% (n=3) was lower than the percentage of patients developing complications in group B 20% (n=5). None of the patients developed hemothorax, pneumothorax or intra-operative bleeding. In this study only one patient (4%) developed compensatory hyperhidrosis at each group. Also, only one patient (4%) developed post-operative temporary Horner’s syndrome at each group.
In this study the percentage of patients developing dyspnea differed between the two groups as 12% (n=3) of patients in group B developed dyspnea which was higher than that of group A 4% (n=1). All of the patients developing dyspnea (n=4) had hospital stay period from one to two days unlike all patients without dyspnea (n=46) who had hospital stay period of only less than one day.
In this study all operations were successfully performed 100% completion rate.
We did not report any case of recurrence in this study, in this study, no organ or major vessel injury during ports introducrion and no mortality either early or late.