The results of thoracoscopic sympathetic trunk transection for palmar hyperhidrosis and sympathetic ganglionectomy for axillary hyperhidrosis

被引:40
作者
Fox, AD [1 ]
Hands, L [1 ]
Collin, J [1 ]
机构
[1] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Surg, Oxford OX3 9DU, England
关键词
thoracoscopic sympathectomy; hyperhidrosis; sweating;
D O I
10.1053/ejvs.1998.0783
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objectives: to review our total experience of thoracoscopic sympathetic trunk transection for the treatment of palmar hyperhidrosis and second and third thoracic sympathetic ganglionectomy for axillary hyperhidrosis. Design: longitudinal cohort study following up consecutive patients for 0.3 to 5.5 years. Subjects: fifty-four consecutive patients undergoing thoracoscopic sympathectomy for hyperhidrosis. Methods: prospective evaluation of immediate technical success, complications, late recurrence of hyperhidrosis and patient acceptability. Results: 100% initial cure for palmar hyperhidrosis, 91% of sympathetic ganglionectomies for axillary hyperhidrosis were technically successful and initially curative. Compensatory, sweating 44% patients, most severe after bilateral sympathetic ganglionectomy. Complications occurred in 14% patients, all resolving without further intervention. There were no cases of Horner's syndrome. 13% patients reported a return of some palmar sweating. 5.4% patients developed recurrent palmar hyperhidrosis at 6, 15 and 21 months postoperatively. Conclusion: transection of the sympathetic trunk between the first and second thoracic sympathetic ganglia initially curves 100% of patients treated primarily for palmar hyperhidrosis. Technically successful 2nd and 3rd thoracic sympathetic ganglionectomy initially cures 100% of patients with axillary hyperhidrosis. Compensatory sweating is common after bilateral sympathectomy, Recurrent palmar hyperhidrosis occurs in 5.4% of cases, but can be cured by a second thoracoscopic sympathectomy. Horner's syndrome is an avoidable complication of thoracoscopic sympathectomy.
引用
收藏
页码:343 / 346
页数:4
相关论文
共 19 条
[1]   PALMAR HYPERHIDROSIS AND ITS SURGICAL TREATMENT - REPORT OF 100 CASES [J].
ADAR, R ;
KURCHIN, A ;
ZWEIG, A ;
MOZES, M .
ANNALS OF SURGERY, 1977, 186 (01) :34-41
[2]   THORACOSCOPIC CERVICODORSAL SYMPATHECTOMY - PRELIMINARY-RESULTS [J].
AHN, SS ;
MACHLEDER, HI ;
CONCEPCION, B ;
MOORE, WS .
JOURNAL OF VASCULAR SURGERY, 1994, 20 (04) :511-519
[3]   HYPERHYDROSIS [J].
CLOWARD, RB .
JOURNAL OF NEUROSURGERY, 1969, 30 (05) :545-&
[4]  
Goetz R. H., 1944, CLIN PROCEED, V3, P102
[5]   THORACOSCOPIC SYMPATHECTOMY [J].
GORDON, A ;
COLLIN, J .
EUROPEAN JOURNAL OF VASCULAR SURGERY, 1994, 8 (03) :247-248
[6]   ROLE OF SYMPATHECTOMY FOR HYPERHIDROSIS [J].
GREENHALGH, RM ;
ROSENGARTEN, DS ;
MARTIN, P .
BMJ-BRITISH MEDICAL JOURNAL, 1971, 1 (5744) :332-+
[7]  
HASHMONAI M, 1994, EUR J SURG, P13
[8]   ENDOSCOPIC SYMPATHECTOMY [J].
HEDERMAN, WP .
BRITISH JOURNAL OF SURGERY, 1993, 80 (06) :687-688
[9]   ENDOSCOPIC THORACIC SYMPATHECTOMY FOR PRIMARY HYPERHIDROSIS OF THE UPPER LIMBS - A CRITICAL ANALYSIS AND LONG-TERM RESULTS OF 480 OPERATIONS [J].
HERBST, F ;
PLAS, EG ;
FUGGER, R ;
FRITSCH, A .
ANNALS OF SURGERY, 1994, 220 (01) :86-90
[10]  
HSU CP, 1994, J AM COLL SURGEONS, V179, P59