Palmar hyperhidrosis is a common problem which leads to embarrassment, frustration, social withdrawal, and low self-esteem. This can be treated either medically with transient effect or open surgery with a single large incision to a minimally invasive surgery with tri-, then bi-, and lastly uniportal VATS with permanent effect. We studied 60 patients aged 11 to 25 years who underwent thoracic biportal VATS sympathectomy for palmar hyperhidrosis between September 2017 and September 2018 in Kafrelsheikh University hospital; they were subdivided into two groups, group A with drain group (30 patient, 13 males and 17 females) and group B without drain group (16 males and 14 females). We noticed that in group B, postoperative pain was less, hospital stay was less, and has better cosmetic results, and this group was more economic. There is no difference between both groups but we preferred without drain method as it is more economic, less postoperative pain and less hospital stay and better cosmetic results. A further study with more number of populations is recommended to confirm the results.
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