胸腔镜胸交感神经干切断术治疗原发性手汗症(附38例报告)

Transthoracic endoscopic thoracic sympathetic ganglionectomy in the treatment of primary palmar hyperhidrosis(A report of 38 cases)

目的总结胸腔镜下胸交感神经干切断术治疗原发性手汗症的临床经验。方法回顾性分析2006年4月～2009年5月胸腔镜下胸交感神经链切断术治疗38例原发性手汗症的临床资料。结果 38例手术均获成功,手掌多汗症状立即消失,平均手术时间(双侧)42min,平均住院4.2 d;术后并气胸1例,胸腔积液2例,经胸腔穿刺治疗后均治愈。发生轻微的代偿性多汗2例。无霍纳氏综合征及死亡病例。随访12个月,均无复发。结论胸腔镜下胸交感神经链切断术是治疗原发性手汗症的一种安全、有效的微创治疗方法。

Objective To summarize the clinical experience with transthoracic endoscopic thoracic sympathetic ganglionectomy in the treatment of primary palmar hyperhidrosis.Methods From April 2006 to May 2009,the clinical data of 38 cases with palmar hyperhidrosis received transthoracic endoscopic thoracic sympathetic ganglionectomy were analyzed retrospectively.Results The operations of 38 cases were performed successfully.The symptom of palmar hyperhidrosis was disappeared immediately after operation.The average operative time（bilateral）was 42 minutes and average hospitalization was 4.2 days.Postoperative pneumothorax and hydrothorax occurred in 1 and 2 cases respectively and via thoracentesis,the 3 cases were cured.The slight compensatory hyperhidrosis occurred in 2 cases.No Horner＇s syndrome and deaths case were found after operation.With follow-up 12 months,no recurrence was found in all cases.Conclusion Transthoracic endoscopic thoracic sympathetic ganglionectomy is a safe and effective minimally invasive therapeutic method for the treatment of primary palmar hyperhidrosis.