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腋下单孔胸腔镜治疗手汗症合并胸腔粘连的临床分析 被引量:3

Clinical analysis of adhesion dissection in transaxillary uniporal video-assisted thoracoscopic surgery for palmar hyperhidrosis
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摘要 目的分析腋下单孔胸腔镜治疗手汗症合并胸腔粘连时分离粘连的可行性及安全性。方法回顾性分析2015年1月至2018年7月我院收治的168例腋下单孔胸腔镜治疗手汗症患者的临床资料,其中男77例、女91例,年龄14~41(24.3±5.4)岁。术中伴发严重胸腔粘连者4例,部分轻微胸腔粘连者12例。对胸腔粘连患者使用人工气胸辅助肺的牵拉,完成粘连分离。对于无法显露胸顶的胸腔粘连患者,根据CT所示奇静脉弓或主动脉弓与肋骨的关系来判定第几肋。结果所有患者均于单孔下顺利完成手术。4例致密粘连者术后放置胃管用作胸腔引流,其中3例于术后第1 d拔除胸腔引流管,1例因术后漏气于术后第11 d拔除胸腔引流管。另外164例轻微胸腔粘连或者无粘连者均于手术次日或手术当天下午顺利出院。出院时手汗均得到控制。结论腋下单孔胸腔镜手术治疗手汗症伴发胸腔粘连是安全可行的。 Objective To analyze the safety and feasibility of the adhesion dissection in transaxillary uniportal thoracoscopy for palmar hyperhidrosis.Methods Data of 168 patients,including 77 males and 91 females with an average age of 14-41(24.3±5.4)years,who received transaxillary uniportal video-assisted thoracoscopic surgery(VATS)for palmar hyperhidrosis from January 2015 to July 2018 were retrospectively analyzed.Severe adhesion was found in 4 patients and mild adhesion was found in 12 patients.Artificial pneumothorax was used to help dissect adhesion.Preoperative CT scan could help locate the rib according to the relative position to azygos vein or aotic arch.Results All of 168 patients were successfully completed with transaxillary uniportal VATS.Then chest tubes were put in the 4 severe adhesion patients.The tube was removed from one patient after 11 days because of air leak,and from the other three patients on the next day.The other 164 patients with or without adhesion were discharged from hospital on the operation day or the next day.Conclusion Adhesion dissection in transaxillary uniportal VATS for palmar hyperhidrosis is safe and feasibile.
作者 王琳 林宗武 奚俊杰 徐松涛 王群 WANG Lin;LIN Zongwu;XI Junjie;XU Songtao;WANG Qun(Department of Thoracic Surgery,Zhongshan Hospital,Fudan University,Shanghai,200032,P.R.China)
出处 《中国胸心血管外科临床杂志》 CAS CSCD 2020年第3期323-326,共4页 Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金 国家自然科学基金(81572295)
关键词 单孔 手汗症 交感神经切断术 粘连 Uniportal palmar hyperhidrosis sympathectomy adhesion
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