Bechara F G, Sand M, Tomi N S, Altmeyer P, Hoffmann K
Department of Dermatology and Allergology, Ruhr-University Bochum, Gudrunstrasse 56, 44791 Bochum, Germany.
Br J Dermatol. 2007 Oct;157(4):739-43. doi: 10.1111/j.1365-2133.2007.08092.x. Epub 2007 Jul 19.
Liposuction-curettage (LC) is an effective surgical therapy option for axillary hyperhidrosis, with less scarring compared with radical excision of axillary skin. Although this method has proven to be effective, the treatment of nonresponders to minimally invasive surgery has not been previously defined. Whether these patients benefit from a second surgical procedure has not been evaluated so far.
To investigate efficacy and side-effects of a second LC with an aggressive rasping cannula in patients with insufficient prior surgery.
Nineteen nonresponders to prior LC (13 female and six male) underwent a second LC with a rasping cannula. Gravimetry was performed before and 8 months after surgery. Side-effects, patient satisfaction, the surgeons' intraoperative evaluation and the Vancouver Scar Scale (VSS) before and after surgery were documented.
Sweat rates showed a reduction of 69% in 17 (89%) patients. Two patients (11%) did not respond to surgery. Eighty-four per cent of all patients were completely satisfied or satisfied with postoperative results. No severe side-effects were observed. The surgeon reported slightly increased difficulties during dissection of dermis from subcutaneous fat in three patients. Assessment of scars showed an excellent aesthetic outcome (mean VSS 0.79 before vs. 1.1 after surgery).
LC using an aggressive cannula is an effective therapy option for patients with insufficient response to prior LC surgery, with a low risk of side-effects.
抽脂刮除术（LC）是治疗腋窝多汗症的一种有效手术治疗方法，与腋窝皮肤根治性切除术相比，瘢痕形成较少。尽管该方法已被证明有效，但此前尚未明确对微创手术无反应者的治疗方法。到目前为止，尚未评估这些患者是否能从二次手术中获益。
探讨对先前手术效果不佳的患者采用 aggressive 锉吸套管进行二次 LC 的疗效和副作用。
19 例对先前 LC 无反应的患者（13 例女性，6 例男性）接受了使用锉吸套管的二次 LC。在手术前和术后 8 个月进行重量测定。记录副作用、患者满意度、外科医生的术中评估以及手术前后的温哥华瘢痕量表（VSS）。
17 例（89%）患者的出汗率降低了 69%。2 例患者（11%）对手术无反应。84%的患者对术后结果完全满意或满意。未观察到严重副作用。外科医生报告有 3 例患者在从皮下脂肪分离真皮时难度略有增加。瘢痕评估显示美学效果极佳（术前平均 VSS 为 0.79，术后为 1.1）。
对于对先前 LC 手术反应不足的患者，使用 aggressive 套管进行 LC 是一种有效的治疗选择，副作用风险较低。
