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首页> 外文期刊>Surgical Endoscopy >Thoracoscopic sympathectomy for palmar hyperhidrosis. Ablate or resect?
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Thoracoscopic sympathectomy for palmar hyperhidrosis. Ablate or resect?

机译：胸腔镜交感神经切除术治疗手掌多汗症。消融还是切除？

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BACKGROUND: Upper thoracoscopic sympathectomy, obtained either by ablation or resection of the appropriate ganglia, is now the preferred treatment for primary palmar hyperhidrosis. Therefore, we undertook a review to compare the relative efficacy of these two techniques. METHODS: A Medline search was performed for the years 1974-99 to identify all published studies of thoracoscopic sympathectomy for hyperhidrosis. RESULTS: In all, 33 studies were identified and divided into two groups-ablation and resection. When the resection method was used, the immediate success rate was 99.76%, whereas the ablation method achieved dry hands in 95.2% of cases (p = 0.00001). Palmar sweating recurred in 0% of patients treated via resection and -4.4% treated with ablation. Ptosis was noted in 0.92% of cases after ablation and in 1.72% after resection (p = 0.017). CONCLUSIONS: Resection yields superior results, yet the majority of surgeons ablate, probably because it is easier, requires a shorter operating time, leads to fewer cases of Horner's syndrome, and because resympathectomy eventually overcomes initial failure.
机译：背景：通过消融或切除适当的神经节获得的上胸腔镜交感神经切除术现在是原发性掌多汗症的首选治疗方法。因此，我们进行了审查以比较这两种技术的相对功效。方法：对1974-99年进行了Medline搜索，以确定所有发表的胸腔镜交感神经切除术治疗多汗症的研究。结果：总共鉴定出33项研究，分为消融和切除两组。使用切除方法时，立即成功率为99.76％，而消融方法在95.2％的病例中达到了干手效果（p = 0.00001）。经切除治疗的患者中0％复发手掌出汗，经消融治疗的患者中-4.4％复发。消融后有0.92％的患者出现下睑下垂，切除术后有1.72％的患者出现下睑下垂（p = 0.017）。结论：切除术取得了较好的效果，但是大多数外科医生消融了，可能是因为它更容易，需要更短的手术时间，导致更少的霍纳氏综合症病例，以及因为交感神经切除术最终克服了最初的失败。

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