Fukushima H, Makimura S, Takae H, Yao Y, Ishimaru S
Department of Surgery II, Tokyo Medical University, Tokyo, Japan.
Kyobu Geka. 2001 May;54(5):379-83.
From June 1996 to June 2000, 477 endoscopic thoracic sympathectomies (ETS) were performed in 242 patients with palmar hyperhidrosis. Among these, 190 patients were studied who received bilateral sympathectomy (T 2-T 3 ganglionectomy) and were followed for over six months. There were 114 females and 76 males with a mean age of 26 years. Palmar hyperhidrosis was found in all patients and axillary hyperhidrosis in 138 (73%) and plantar hyperhidrosis in 186 (98%) preoperatively. The degrees of palmar, axillary and plantar perspiration were checked immediately (1-2 weeks, 190 patients), as well as in the early (1 year, 190 patients) and late (2-4 years, 65 patients) postoperative periods. In all patients, the hands became dry or normal condition immediately after the operation, and this continued to late period. Disappearance or decrease of axillary sweating was found in 128 patients (93%) in the immediate period and 107 patients (78%) in the early period. Disappearance or decrease of plantar sweating was found in 134 patients (72%) in the immediate period and 115 patients (62%) in the early period. Among 65 patients examined in the late period, axillary hyperhidrosis was found in 24 (37%), and plantar hyperhidrosis was found in 52 (80%). Compensatory sweating was found in 80 patients (42%) in the immediate period and 137 patients (72%) in the early period. In the late period, compensatory sweating developed in 56 patients (86%). In the immediate period, 175 patients (92%) were satisfied with the results of the operation, but this decreased to 83% and 72% at early and late period. However ETS was remarkably effective for palmar or axillary hyperhidrosis and relatively effective for plantar hyperhidrosis, but development of compensatory sweating did occur in some cases.
1996年6月至2000年6月,对242例手掌多汗症患者实施了477例内镜胸交感神经切除术(ETS)。其中,对190例行双侧交感神经切除术(T2 - T3神经节切除术)的患者进行了研究,并随访6个月以上。患者中女性114例,男性76例,平均年龄26岁。所有患者均有手掌多汗症,术前138例(73%)有腋窝多汗症,186例(98%)有足底多汗症。术后即刻(1 - 2周,190例患者)、早期(1年,190例患者)和晚期(2 - 4年,65例患者)均检查了手掌、腋窝和足底的出汗程度。所有患者术后手部立即变为干燥或正常状态,并持续至晚期。术后即刻128例患者(93%)腋窝出汗消失或减少,早期107例患者(78%)腋窝出汗消失或减少。术后即刻134例患者(72%)足底出汗消失或减少,早期115例患者(62%)足底出汗消失或减少。在晚期检查的65例患者中,24例(37%)有腋窝多汗症,52例(80%)有足底多汗症。术后即刻80例患者(42%)出现代偿性出汗,早期137例患者(72%)出现代偿性出汗。在晚期,56例患者(8