单孔法胸腔镜下双侧胸交感神经链切断术治疗手汗症89例分析

Analysis of 89 cases of palmar hyperhidrosis treated by thoracic sympathetic chain amputation through single hole vats

目的分析单孔法电视胸腔镜下胸交感链切断术治疗手汗症的可行性及疗效。方法 2007-05—2011-05我科接诊原发性手汗症患者89例,男47例,女42例,均于电视胸腔镜下行双侧T3-4交感神经链切断术手术治疗,手术均在单腔气管插管下进行,术中监测双手温度。结果本组全部患者均顺利完成手术,术后手汗立即消失,双手干燥、红润;无严重并发症或死亡。术后定期随访,未见复发,其中发现代偿性多汗8例,除1例外均较轻微,对日常生活影响不大。结论单孔法胸腔镜下双侧T3-4胸交感神经链切断术是治疗手汗症理想、安全、有效的方法,代偿性多汗发生率较高,术前应向患者讲明。

Objective To analyze the practicability and effect of the treatment of palmar hyperhidrosis by thoracic sympa- thetic chain amputation through single hole video-assisted thoracoscopic. Methods From May 2007 to May 2011, 89 cases of primary hyperhidrosis patients were treated by bilateral T34 sympathectomy through video-assisted thoracoscopic in our depart- ment, male 47 cases, and female 42 cases. Operations were carried out in the single lumen tracheal intubation, with monitoring of the temperature of hands. Results All the operations were completed successfully. Hand perspiration disappeared and the hands turned to be dry and red immediately after operation. No serious complications or death happened. Postoperative follow- up showed no recurrence. The compensatory hyperhidrosis was found in 8 cases, 7 cases of them were mild and had little im pact on daily life. Conclusion Bilateral T3 4 sympathectomy through single hole video-assisted thoracoscopic is an ideal, safe, effective method for palmar hyperhidrosis with high incidence of compensatory hyperhidrosis, which should be told to the pa- tients before operation.