Reply to Garcia Franco et al.

We have discussed the letter to the editor written by Garcia Franco et al. [1], relating to our study [2]. We also reviewed the article by the same authors in 2011, entitled ‘Prospective study of percutaneous radiofrequency sympathicolysis in severe hyperhidrosis and facial blushing: efficacy and safety findings’ [3]. This article is closely related to the aim of our study. Unfortunately, we must confess that we overlooked it while preparing our manuscript: we probably did not come across it whilst searching PubMed for related keywords (sympathectomy, hyperhidrosis, surgery and radiofrequency). We sincerely regret our inability to cite this valuable article.

We have been performing the radiofrequency ablation method for treatment of palmar hyperhidrosis since 2007. We prefer to use an approach at the T4 sympathetic ganglion level. Our thoracic surgery department also chooses this level for surgical approach. We have previously presented this technique in several symposia and congresses and believe that it is the best method for treatment of palmar hyperhidrosis. We submitted our assertion, in another article to the journal 'Agri' in January 2012 and it was published in January 2013 [4].

We believe it is not necessary to compare cost-effectiveness of the surgical operation and interventional treatment. Our approach is, as expected, more cost-effective. There are many other supportive studies about outpatient procedures being cost-effective.

We reported all of the surgical complications in our manuscript, however, the minimal complications observed in our study may be related to the experience of the surgical team, which has better outcomes.

Conflict of Interest: none declared.

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