• Sui Chen, Peipei Zhang, Tianci Chai, Zhimin Shen, Mingqiang Kang, and Jiangbo Lin.
• Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
• Medicine (Baltimore). 2019 Oct 1; 98 (42): e17272.

BackgroundPalmar hyperhidrosis (PH) is a common sympathetic disorder that reduces patient' quality of life. Video-assisted thoracoscopic sympathectomy (VTS) is a popular and effective treatment for PH. However, there is substantial controversy about the treatment of PH with VTS at the T3 or T4 level. We will compare the quality metrics of VTS at T3 versus T4 to determine the optimal level for VTS.MethodsWe will search PubMed, Scopus, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials, and the Google Scholar databases for relevant clinical trials published in any language before March 31, 2019. Randomized controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies, and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, sex of patient, and ethnicity of patient will be performed.ResultsThe results of this study will be published in a peer-reviewed journal.ConclusionsThe results of this study will provide reliable evidence for the development of optimal treatment strategies for patients with PH. Owing to the characteristics of disease and intervention methods, randomized controlled trials may not be sufficient. We will include high-quality nonrandomized controlled trials, but this may lead to high heterogeneity and may affect the reliability of the results.Prospero Registration NumberCRD42018116607.

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