400042 重庆,陆军特色医学中心胸外科
Received:12 November 2021,
Revised:2022-04-24,
Published:15 July 2022
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Xuehai LIU, Yanning LI, Jianglong WANG, et al. Micro-double-port endoscopic thoracic sympathectomy for treatment of primary palmar hyperhidrosis: report of 25 cases[J]. Journal of Army Medical University, 2022, 44(13): 1390-1394.
Xuehai LIU, Yanning LI, Jianglong WANG, et al. Micro-double-port endoscopic thoracic sympathectomy for treatment of primary palmar hyperhidrosis: report of 25 cases[J]. Journal of Army Medical University, 2022, 44(13): 1390-1394. DOI: 10.16016/j.2097-0927.202111035.
目的
2
总结微小双孔法胸腔镜双侧胸交感神经链切断术在治疗手汗症中的临床应用。
方法
2
回顾性分析2021年4月至2022年3月于陆军特色医学中心胸外科接受微小双孔法胸腔镜双侧胸交感神经链切断术的25例患者的临床资料
其中男性9例,女性16例,年龄(23.0±5.1)岁,术中于第3或4肋间,腋前线和腋中线分别取两条0.5 cm切口,置入两枚5 mm穿刺器,使用5 mm针型胸腔镜,建立人工气胸下手术。
结果
2
25例患者均手术顺利,术后均正常出院,1例患者术后出现右侧少量气胸(术后12 d复查胸片检查提示气胸吸收),手汗及伴随部位多汗明显减少
手温升高达到预期;其中手术时间(23.2±4.7)min,术中出血量(4.2±2.3)mL,术后住院时间(0.6±0.4)d,术后疼痛评分(1.0±0.6)分,治疗有效率100%,效果满意度100%,15例患者术后出现轻度代偿性多汗。
结论
2
微小双孔法胸腔镜双侧胸交感神经链切断术治疗手汗症,切口小且美观,操作安全便捷,手术时间和术后住院时间短,术后无明显疼痛感,效果满意。
Objective
2
To summarize the clinical application of micro-double-port endoscopic thoracic sympathectomy in treatment of primary palmar hyperhidrosis.
Methods
2
Clinical data of 25 patients with primary palmar hyperhidrosis undergoing sympathectomy in our department from April 2021 to March 2022 were collected and retrospectively analyzed. They were 9 males and 16 females
at an age of 23.0±5.1 (15
35) years. During the operation
two 0.5-cm incisions were made at the anterior axillary line and the mid-axillary line of the 3rd or 4th intercostal space
then two 5-mm trocars were placed
and a 5-mm needle-type thoracoscope was used to establish an artificial pneumothorax. R3 and R4 thoracic sympathetic chains were transected.
Results
2
All 25 patients successfully received the operation and were discharged upon recovery. One patient developed a small amount of pneumothorax on the right side after operation
and re-examination with chest X-ray filming showed that the pneumothorax was absorbed in 12 d after operation. The symptoms of hyperhidrosis on the hands all disappeared
and hand temperature was increased as expected. The operation time was 23.2±4.7 min
the intraoperative blood loss was 4.2±2.3 mL
the postoperative hospital stay was 0.6±0.4 d
and the postoperative pain score was 1.0±0.6. The treatment effective rate was 100%
and the satisfaction of outcome was 100%. Fifteen patients had mild compensatory hyperhidrosis postoperatively.
Conclusion
2
In treatment of primary palmar hyperhidrosis
micro-double-port endoscopic thoracic sympathectomy is characterized by small incision
safe and easy operation
short operation time and postoperative hospital stay
and no obvious pain and more satisfying outcomes.
涂远荣, 刘彦国. 中国手汗症微创治疗临床指南(2021年版)[J]. 中国胸心血管外科临床杂志, 2021, 28(10): 1133-1139.
TU Y R, LIU Y G. Clinical guideline for minimally invasive treatment of palmar hyperhidrosis in China(2021)[J]. Chin J Clin Thorac Cardiovasc Surg, 2021, 28(10): 1133-1139.
LAI F C, TU Y R, LI Y P, et al . Nation wide epidemiological survey of primary palmar hyperhidrosis in the People's Republic of China[J ] . Clin Auton Res, 2015, 25(2): 105-108. DOI: 10.1007/s10286-014-0259-5.
MOL A, MUENSTERER O J. Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series[J]. Surg Endosc, 2021, 35(7): 3313-3319. DOI: 10.1007/s00464-020-07769-0.
LIN J B, KANG M Q, CHEN J F, et al . Transareolar single-port endoscopic thoracic sympathectomy with a flexible endoscope for primary palmar hyperhidrosis: a prospective randomized controlled trial[J ] . Ann Transl Med, 2020, 8(24): 1659. DOI: 10.21037/atm-20-7399.
杨胜生, 朱立桓, 陈炜生, 等. 经脐内镜下胸交感神经节切除术[J]. 中华胸心血管外科杂志, 2013, 29(3): 167-168. DOI: 10.3760/cma.j.issn.1001-4497.2013.03.012.
YANG S S, ZHU L H, CHEN W S, et al . The investigation of endoscopic transumbilical thoracic sympathectomy in experimental models[J ] . Chin J Thorac Cardiovasc Surg, 2013, 29(3): 167-168. DOI: 10.3760/cma.j.issn.1001-4497.2013.03.012.
梁宝磊, 蔡庆勇, 梁贵友, 等. 剑突下单孔胸腔镜同期处理双侧胸部疾病的疗效分析[J]. 中国胸心血管外科临床杂志, 2018, 25(12): 1064-1067.
LIANG B L, CAI Q Y, LIANG G Y, et al . Outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases[J ] . Chin J Clin Thorac Cardiovasc Surg, 2018, 25(12): 1064-1067.
AKIL A, SEMIK M, FISCHER S. Efficacy of miniuniportal video-assisted thoracoscopic selective sympathectomy (ramicotomy) for the treatment of severe palmar and axillar hyperhidrosis[J]. Thorac Cardiovasc Surg, 2019, 67(5): 415-419. DOI: 10.1055/s-0038-1642030.
王伟森, 肖大伟, 谢泽锋, 等. 人工气胸在原发性手汗症微创手术中的应用及疗效[J]. 中国临床研究, 2021, 34(1): 65-68. DOI: 10.13429/j.cnki.cjcr.2021.01.014.
WANG W S, XIAO D W, XIE Z F, et al . Effect of artificial pneumothorax in minimally invasive surgery for primary palmar hyperhidrosis[J ] . Chin J Clin Res, 2021, 34(1): 65-68. DOI: 10.13429/j.cnki.cjcr.2021.01.014.
HORNBERGER J, GRIMES K, NAUMANN M, et al . Recognition, diagnosis, and treatment of primary focal hyperhidrosis[J ] . J Am Acad Dermatol, 2004, 51(2): 274-286. DOI: 10.1016/j.jaad.2003.12.029.
CERFOLIO R J, DE CAMPOS J R M, BRYANT A S, et al . The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis[J ] . Ann Thorac Surg, 2011, 91(5): 1642-1648. DOI: 10.1016/j.athoracsur.2011.01.105.
LIU Y G, LI H, ZHENG X, et al . Sympathicotomy for palmar hyperhidrosis: the association between intraoperative palm temperature change and the curative effect[J ] . Ann Thorac Cardiovasc Surg, 2015, 21(4): 359-363. DOI: 10.5761/atcs.oa.14-00270.
AMBROGI V, CAMPIONE E, MINEO D, et al . Bilateral thoracoscopic T2 to T3 sympathectomy versus botulinum injection in palmar hyperhidrosis[J ] . Ann Thorac Surg, 2009, 88(1): 238-245. DOI: 10.1016/j.athoracsur.2009.04.003.
何平, 张江河, 燕荣帅, 等. 注射性A型肉毒素中毒9例临床诊治分析[J]. 第三军医大学学报, 2021, 43(17): 1684-1688. DOI: 10.16016/j.1000-5404.202103069.
HE P, ZHANG J H, YAN R S, et al . Diagnosis and treatment of botulism after botulinum toxin type A injections: report of 9 cases[J ] . J Third Mil Med Univ, 2021, 43(17): 1684-1688. DOI: 10.16016/j.1000-5404.202103069.
GARCÍA-BARQUÍN P, AQUERRETA BEOLA J D, BONDÍA GRACÍA J M, et al . Percutaneous CT-guided sympathicolysis with radiofrequency for the treatment of palmar hyperhidrosis[J ] . J Vasc Interv Radiol, 2017, 28(6): 877-885. DOI: 10.1016/j.jvir.2017.02.025.
FENG X, XIONG X L, JIN E, et al . Needlescopic video-assisted thoracic bilateral T4 sympathicotomy for the treatment of primary palmar hyperhidrosis: an analysis of 200 cases[J ] . Thorac Cardiovasc Surg, 2019, 67(5): 395-401. DOI: 10.1055/s-0038-1645872.
易昌盛, 岳鹏, 胡文腾, 等. 无管化电视胸腔镜手术治疗原发性手汗症的单中心回顾性队列研究[J]. 中国胸心血管外科临床杂志, 2022, 29(3): 318-322.
YI C S, YUE P, HU W T, et al . Tubeless video-assisted thoracoscopic surgery for primary palmar hyperhidrosis: a retrospective cohort study in a single center[J ] . Chin J Clin Thorac Cardiovasc Surg, 2022, 29(3): 318-322.
CHEN J F, LIU Y G, YANG J, et al . Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: a retrospective multicenter study in China[J ] . Surgery, 2019, 166(6): 1092-1098. DOI: 10.1016/j.surg.2019.05.039.
李冬, 沈琦斌, 顾勤花, 等. 加速康复外科在胸腔镜胸交感神经切断术治疗手汗症中的应用[J]. 中国现代医生, 2020, 58(4): 104-107.
LI D, SHEN Q B, GU Q H, et al . Application of enhanced recovery after surgery in thoracoscopic thoracic sympathectomy for palmar hyperhidrosis[J ] . China Mod Dr, 2020, 58(4): 104-107.
沈诚, 常帅, 周坤, 等. 加速康复外科和日间手术模式在胸外科中的应用现状及发展前景[J]. 中国肺癌杂志, 2020, 23(9): 800-805.
SHEN C, CHANG S, ZHOU K, et al . The present situation and prospect of day surgery and enhanced recovery after surgery in thoracic surgery[J ] . Chin J Lung Cancer, 2020, 23(9): 800-805.
邵广强, 庞大志, 张吉天, 等. 超微5mm单孔胸腔镜交感神经链切断术在原发性手汗症手术中的临床应用[J]. 中国胸心血管外科临床杂志, 2022, 29(3): 306-310.
SHAO G Q, PANG D Z, ZHANG J T, et al . Clinical application of ultra-micro 5 mm single-port endoscopic thoracic sympathicotomy in selected patients with primary palmar hyperhidrosis[J ] . Chin J Clin Thorac Cardiovasc Surg, 2022, 29(3): 306-310.
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