الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hyperhidrosis can be defined as a pathologic condition characterized by excessive sweating beyond the body’s physiological needs to maintain its temperature within an adequate range.
Its incidence is about 2% of the world population and the patients with primary hyperhidrosis usually present with sweating complaint dating from the first decade of life (remarkably in hands), leading to a negative impact on their QoL.
The gold standard for treatment of palmar and palmer-axillary hyperhidrosis is thoracoscopic sympathectomy.
Preoperative investigations such as thyroid profile, random blood sugar or chest x ray are of great importance for proper diagnosis and differentiation between primary and secondery hyperhidrosis.
Whitson et al., recommend clipping the sympathetic nerve, on the ground that, in cases of severe compensatory sweating, removal of the clip(s) will allow regeneration of the nerve, leading to improvement of the compensatory sweating.
A randomized comparative prospective study was conducted in general and vascular surgery departments in Ain shams university hospital and Nasser institute hospital for research and treatment. The study included 20 patients diagnosed with primary hyperhidrosis either palmer and/or axillary.
These patients were allocated randomly into 2 groups, group A was treated using clipping technique and group B was treated using electrocautery technique.
In our study the operative time in group A ranged from 55 – 81 minutes with mean time of 68.00 ± 8.78 minutes, While in group B, Time ranged from 45 – 70 minutes with mean time of 55.20 ± 8.59 minutes and that difference was statistically significant (P=0.004),
Despite that the difference between the operative time of the 2 groups was statistically significant, yet it was only about 12 minutes.
In our study compensatory hyperhidrosis was developed in 2 cases (20%) in group A, but in group B there was only one case (10%) (P = 0.531), While in group A there was 1 case (10%) of wound infection and no such cases was reported in group B (P = 0.305), No cases in our study developed pneumothorax, haemothorax or required conversion to open thoracotomy no cases showed cardiac complication or Horner`s syndrome.
The previous results indicated high success rate for both procedures and that there is no statistically significant difference between the two techniques regarding the efficacy, yet the clipping technique offered the theoretical reversibility.
In our study no patients requested reversal of the effect even those who suffered from postoperative compensatory hyperhidrosis and all patients were satisfied with the result of the procedure.