Riet M, Smet A A, Kuiken H, Kazemier G, Bonjer H J
Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
Surg Endosc. 2001 Oct;15(10):1159-62. doi: 10.1007/s004640090097. Epub 2001 Aug 16.
Compensatory hyperhidrosis is a troublesome complication of thoracoscopic sympathectomy for hyperhidrosis. After extensive resection of the second through the fourth ganglion (T2-4), as well as after limited resection of the second ganglion (T2), the reported incidence of compensatory hyperhidrosis ranges as high as 50-97%. The purpose of this study was to determine whether the incidence of compensatory hyperhidrosis can be reduced by limiting the thoracoscopic sympathectomy to another level, the third ganglion.
We analyzed 28 thoracoscopic sympathectomies for palmar and/or axillary hyperhidrosis. In all patients, the sympathetic chain was transected cranially and caudally to the third ganglion (T3 dissection). Long-term follow-up was conducted by interviewing patients using standardized questionnaires.
The surgery was effective in all patients. After a median follow-up of 3.5 years, compensatory hyperhidrosis was not recorded in any of the patients. There were no recurrences of hyperhidrosis.
Limited thoracoscopic sympathectomy at the level of the third ganglion is effective and seems to prevent compensatory hyperhidrosis.
代偿性多汗是胸腔镜下多汗症交感神经切除术的一种麻烦并发症。在广泛切除第二至第四神经节（T2 - 4）后，以及在有限切除第二神经节（T2）后，报道的代偿性多汗发生率高达50 - 97%。本研究的目的是确定通过将胸腔镜交感神经切除术限制在另一个水平，即第三神经节，是否可以降低代偿性多汗的发生率。
我们分析了28例因手掌和/或腋窝多汗症而进行的胸腔镜交感神经切除术。在所有患者中，交感神经链在第三神经节的头侧和尾侧横断（T3解剖）。通过使用标准化问卷对患者进行访谈来进行长期随访。
手术对所有患者均有效。中位随访3.5年后，所有患者均未记录到代偿性多汗。多汗症无复发。
在第三神经节水平进行有限的胸腔镜交感神经切除术是有效的，并且似乎可以预防代偿性多汗。
