Little J M, May J
Aust N Z J Surg. 1975 May;45(2):143-6. doi: 10.1111/j.1445-2197.1975.tb05745.x.
Twenty-nine upper dorsal sympathectomies have been carried out in 18 patients and a comparison made of the supraclavicular with the axillary approach to the upper thoracic sympathetic chain. Thirteen of these operations were carried out for essential hyperhidrosis, 15 for ischaemia in the hand and one for post-traumatic pain syndrome. Fourteen sympathectomies were carried out through the axilla and 15 through the supraclavicular approach. Post-operative pain was felt to be somewhat more severe when the axillary approach was used, but other complications were infrequent and hospital stay was slightly shorter in the axillary group. The axillary approach was felt to offer superior exposure, the capability for wider sympathetic excision, good cosmetic results, avoidance of Horner's syndrome and low morbidity. In the absence of lung disease or the need for a direct exploration of the root of the neck, the axillary approach is to be preferred for upper dorsal sympathectomy.
对18例患者实施了29次上胸段交感神经切除术，并对经锁骨上入路与经腋窝入路处理上胸段交感神经链进行了比较。其中13例手术用于治疗原发性多汗症，15例用于治疗手部缺血，1例用于治疗创伤后疼痛综合征。14例交感神经切除术经腋窝进行，15例经锁骨上入路进行。采用腋窝入路时，术后疼痛感觉稍重，但其他并发症较少，腋窝组住院时间略短。腋窝入路被认为具有更好的显露效果、能够更广泛地切除交感神经、美容效果好、可避免霍纳综合征且发病率低。在没有肺部疾病或无需直接探查颈部根部的情况下，上胸段交感神经切除术首选腋窝入路。
