胸腔镜下胸交感神经干切断术治疗手汗症200例近远期随访报告

Follow-up observations of 200 cases of endoscopic thoracic sympathectomy for palmar hyperhidrosis

目的评价电视胸腔镜行双侧T2～T4交感神经干切断术治疗手汗症的结果、并发症及术后生活质量.方法200例术后患者采取门诊或电话随访,随访1～28个月,平均18.4月.结果200例中失访8例,随访192例术后手及腋窝多汗症状均消失,无一例复发.术后无严重并发症,主要并发症为转移代偿性多汗27.1%(52/192),气胸和肺不张各1例.其中女性及重度手汗症患者术后发生率稍高,与年龄无关.结论胸腔镜下T2～T4交感神经干切断术治疗手汗症有效、安全、可靠,提高了患者术后生活质量,患者对手术的满意度比较高.但是术前应对所有患者强调常见并发症特别是转移代偿性多汗发生的可能.

Objective To assess the outcomes, complications, and quality of life following endoscopic thoracic sympathectomy （ETS） of the T2 - T4 ganglia for treating primary palmar hyperhidrosis （PH）. Methods A total of 200 cases were followed with clinic checkups or telephone inquiries for a period of 1 -28 months （mean, 18.4 months）. Results Of the 200 cases, 8 cases were loss of follow - up and 192 cases obtained a complete and fully satisfactory alleviation of palmer and axillary hyperhidrosis. No recurrence and severe complications were found. The prime complication was compensatory hyperhidrosis （52/192, 27.1% ） , whose incidence was slightly higher in female and severe patients and unrelated to age. Other complications included 1 case of pneumothorax and 1 case of pulmonary atelectasis. Conclusions Endoscopic thoracic sympathectomy of the T2 - T4 ganglia for palmar hyperhidrosis is effective, safe and reliable. The procedure improves patients＇ quality of life and gives satisfactory outcomes. However, all patients should be informed of the common complications, particularly compensatory hyperhidrosis, before the surgery.