Background: Primary axillary hyperhidrosis could be managed with various
video-assisted thoracoscopic sympathectomy procedures. We compared two
levels of ganglion excision for managing primary axillary hyperhidrosis: T3-T4
and T4. Methods: A prospective study was conducted from March 2019 to January
2023. It enrolled seventy patients with axillary hyperhidrosis and randomly
assigned them to two groups. Thirty-five patients were surgically treated with
thermal ablation of T3-T4, while 35 patients were surgically treated with thermal
ablation of T4 only. Both groups were followed up at one, six, and twelve months
after surgery. The presence and severity of associated compensatory sweating
(CS) were evaluated. Patient satisfaction was assessed using a questionnaire.
Results: The mean age was 26.7±8.1 years in the T3-T4 group and 25.9±7.3 years in
the T4 group. There were 19 (54.2%) males in T3-T4 group and 17 males (48.5%)
in T4 group. Family history was positive in 25 patients (71.4%) in T3-T4 group
and 23 patients (65.7%) in T4 group. No mortality, postoperative complications,
or thoracotomy conversions were observed in both groups. The rate of immediate
operative success was 100% in both groups. The T4 group showed a significant
absence of CS after 1, 6, and 12 months after surgery (p