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首页> 外文期刊>Surgical Endoscopy >Endoscopic thoracic sympathectomy for primary palmar hyperidrosis.
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Endoscopic thoracic sympathectomy for primary palmar hyperidrosis.

机译：内镜下胸交感神经切除术治疗原发性手掌多汗症。

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BACKGROUND: Primary hyperhidrosis is a disorder that is characterized by excessive sweating in disproportion to that required for thermoregulation. In most cases, this is aggravated by emotional factors and by heat. Hyperhidrosis can be seen in the palms of the hands, armpits, soles of the feet and face. The principal characteristic of this disease is the intense discomfort of patients, which affects their social and professional life. Treatment modalities include topical application of aluminum chloride, iontophoresis, anticholinergics, botulinum toxin injection, liposuction, excision of sweat glands, and thoracic sympathectomy. METHODS: Between January 1998 and August 2007, a prospective study of endoscopic thoracic sympathectomies for palmar hyperhidrosis was undertaken based on case histories and a prospective pre- and postoperative questionnaire survey. The sample comprised of 322 patients with a mean age of 24 years. At Apollo Hospital, New Delhi, India, bilateral video-assisted thoracoscopic T3 level sympathectomies were performed in all cases. RESULTS: All patients had immediate cessation of palmar hyperhidrosis. The mean postoperative stay was 1.1 days. A questionnaire was completed based on their response to a telephone conversation or e-mail. A paired t test and Wilcoxon test was performed on these data and it showed significant improvement in quality of life. Compensatory sweating was found to be the most troublesome side effect for all patients. It was seen in 63% of the patients. This is similar to other reports of compensatory sweating; however, the figure decreases to 29% if we disregard the percentage of patients who reported only mild compensatory sweating. CONCLUSION: In view of the low morbidity and zero mortality rate of this surgical technique, we recommend it as a method of treatment for palmar hyperhidrosis. Thoracic sympathectomy eliminates palmar hyperhidrosis with minimal recurrence (1% in our series) and produces a high rate of patient satisfaction.
机译：背景：原发性多汗症是一种以出汗过多而与体温调节所不成比例为特征的疾病。在大多数情况下，情绪因素和热量会加剧这种情况。多汗症可见于手掌，腋窝，脚掌和面部。该疾病的主要特征是患者的强烈不适感，这会影响他们的社交和职业生活。治疗方式包括局部应用氯化铝，离子电渗疗法，抗胆碱能药，肉毒杆菌毒素注射，吸脂，汗腺切除和胸交感神经切除术。方法：在1998年1月至2007年8月之间，根据病例历史和术前和术后的问卷调查，对内镜下胸交感神经切除术治疗手掌多汗症进行了前瞻性研究。该样本包括322名平均年龄为24岁的患者。在印度新德里的阿波罗医院，所有病例均进行了双侧电视胸腔镜T3水平交感神经切除术。结果：所有患者均立即停止手掌多汗症。术后平均住院时间为1.1天。根据他们对电话交谈或电子邮件的答复，问卷已完成。对这些数据进行了配对t检验和Wilcoxon检验，结果表明生活质量得到了显着改善。发现代偿性出汗是所有患者中最麻烦的副作用。在63％的患者中可见。这与其他关于补偿性出汗的报道相似。但是，如果我们忽略仅报告轻度代偿性出汗的患者的百分比，则该数字降至29％。结论：鉴于该手术技术的低发病率和零死亡率，我们建议将其作为治疗手足多汗症的一种方法。胸交感神经切除术以最小的复发率（本系列的1％）消除了手掌多汗症，并提高了患者的满意度。

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