超声气化技术切除交感神经治疗手掌多汗症的研究

A new and effective method to perform thoracoscopic sympathectomy for palmar hyperhidrosis:ultra-sound vibrating vaporization

目的探讨使用超声气化法实施胸腔镜辅助下交感神经节切除技术的优劣性及如何预防手术后并发症。方法回顾分析使用超声气化法实施胸腔镜辅助下交感神经节切除术的手掌多汗症患者67例。单纯型手掌多汗症手术组切除T2和T3交感神经节,合并腋下和(或)足掌多汗症的混合型手掌多汗症患者切除T2、T3和T4交感神经节。结果无手术及术后死亡病例,气胸发生率为14.9%,未发生术后Horner综合症,手术失败率为1.5%,术后代偿性多汗发生率为38.8%,手术后原发症状总体缓解率为95.5%,总体满意率为92.5%。结论应用超声气化法实施胸腔镜辅助下交感神经节切除术安全、效果好,能有效降低手术后代偿性多汗并发症的发生。

Objective To evaluate effect of the ultra-sound vibrating vaporization in the procedure of thoracoscopic sympathectomy for palmar hyperhidrosis, and to study how to prevent the postoperative complications. Methods Retrospective review was conducted in 67 patients who were undergone thoracoscopic sympathectomy by using harmonic scalpel. T2 and T3 ganglions were resected in patients with pure palmar hyperhidrosis ; T2, T3 and T4 ganglions were rejected in pa- tients with combined palmar hyperhidrosis. Results There was no mortality during operation and postoperation. The rate of postoperative pneumothorax was 14.9%. No Homer＇ s syndrome occurred, and operative failure rate was 1.5%. 38. 8% patients had postoperative compensatory sweating. Preoperative symptoms resolved completely or significantly improved was in 95.5 % of all patients. Overall satisfaction rate was 92.5%. Conclusion Thoracoscopic sympathectomy performed by using ultra-sound vibrating vaporization is a safe and effective method in managing palmar hyperhidrosis, which may decrease the high rate of postoperative compensatory sweating.