Nicolas C, Grosdidier G, Granel F, Barbaud A, Schmutz J L
Service de Dermatologie, Hôpital Fournier, 36, quai de la bataille, 54035 Nancy Cedex.
Ann Dermatol Venereol. 2000 Dec;127(12):1057-63.
Transthoracic endoscopic sympathectomy for palmar hyperhidrosis is a safe and effective method. However, no radical and definite treatment exists for plantar hyperhidrosis. We report our experience, immediate post-operative and mid-term results after transthoracic and lumbar endoscopic sympathectomy for palmar and plantar hyperhidrosis.
One hundred and seven of 117 patients cured between January 94 and December 98, answered a questionnaire regarding their past history, the early post-operative results, side effects and complications caused by the operation and mid-term results with particular emphasis on patient satisfaction.
Seventy-eight thoracic and lumbar endoscopic sympathectomies and 125 thoracic endoscopic sympathectomies were performed. The patients were 30 men (median age 30 years) and 77 women (median age 26 years). Only women underwent lumbar endoscopic sympathectomy because of risk of retrograde ejaculation. No severe complications were noted. The success rate was 96 p. 100 for palmar hyperhidrosis and 98,5 p. 100 for plantar hyperhidrosis. No recurrences were noted in 97 p. 100 of the patients with median follow-up of 28 months. The main side effect was compensatory sweating which was the reason for dissatisfaction for 5 p. 100 of the patients. Cutaneous dryness and gustatory sweating were also described. However, 95 p. 100 of the patients were "satisfied" or "very satisfied".
Our experience proved that lumbar endoscopic sympathectomy is as safe and effective for treatment of plantar hyperhidrosis, as thoracic endoscopic sympathectomy for palmar hyperhidrosis.
经胸交感神经内镜切除术治疗手掌多汗症是一种安全有效的方法。然而,足底多汗症尚无根治性的确切治疗方法。我们报告经胸和经腰交感神经内镜切除术治疗手掌和足底多汗症的经验、术后即刻及中期结果。
1994年1月至1998年12月间治愈的117例患者中有107例回答了关于其既往病史、术后早期结果、手术引起的副作用和并发症以及中期结果的问卷,特别强调了患者满意度。
共进行了78例胸腰段交感神经内镜切除术和125例胸段交感神经内镜切除术。患者中男性30例(中位年龄30岁),女性77例(中位年龄26岁)。因逆行射精风险,仅女性接受了腰段交感神经内镜切除术。未观察到严重并发症。手掌多汗症的成功率为96%,足底多汗症的成功率为98.5%。中位随访28个月,97%的患者未复发。主要副作用是代偿性出汗,这是5%的患者不满意的原因。还描述了皮肤干燥和味觉性出汗。然而,95%的患者“满意”或“非常满意”。
我们的经验证明,腰段交感神经内镜切除术治疗足底多汗症与胸段交感神经内镜切除术治疗手掌多汗症一样安全有效。