Fibla Juan J, Molins Laureano, Mier Jose Manuel, Vidal Gonzalo
Department of Thoracic Surgery, Hospital Universitari Sagrat Cor, C/Viladomat 288, Barcelona 08029, Spain.
Interact Cardiovasc Thorac Surg. 2009 Dec;9(6):970-2. doi: 10.1510/icvts.2009.212365. Epub 2009 Aug 10.
Main cause of dissatisfaction after videothoracoscopic (VATS) sympathectomy in the treatment of hyperhidrosis (HH) and facial blushing (FB) is compensatory sweating (CS). Sympathetic nerve (SN) clipping permits to revert the block effect by removing the clips in case of an intolerable CS. We present our experience with this technique. Sixty-one patients diagnosed for HH and/or FB were operated on VATS SN clipping. Clipping levels varied in function for the sort of disease: FB: T2, palmar HH: T3, axillary HH: T4, palmar-axillary HH: T3-4. Results were evaluated 1 week, 3 months and 12 months after surgery. Fifty-eight of the 61 patients showed improvement of their symptoms (95%). There were minor complications in three patients (5.5%). CS was seen in 38/61 (62.2%), being labelled as mild in 33/61 (54%) and severe in 5/61 patients (8.2%), no patient qualified it as intolerable and it was not necessary to remove the clips for CS in any case. SN clipping by VATS is a safe and effective procedure for the management of FB and palmar/axillary HH. Levels of CS are similar or lesser than with the standard sympathicotomy and, if necessary, this technique allows to revert the sympathetic block removing the clips.
电视胸腔镜交感神经切除术（VATS）治疗多汗症（HH）和面部潮红（FB）后患者不满意的主要原因是代偿性出汗（CS）。交感神经夹闭术可在出现无法耐受的CS时通过移除夹子来逆转阻断效果。我们介绍了我们在这项技术上的经验。61例被诊断为HH和/或FB的患者接受了VATS交感神经夹闭术。夹闭水平根据疾病类型而有所不同：FB：T2，手掌多汗症：T3，腋窝多汗症：T4，手掌-腋窝多汗症：T3-4。在术后1周、3个月和12个月对结果进行评估。61例患者中有58例症状改善（95%）。3例患者出现轻微并发症（5.5%）。61例中有38例（62.2%）出现CS，其中33例（54%）为轻度，5例（8.2%）为重度，没有患者认为其无法耐受，且在任何情况下都无需因CS而移除夹子。VATS交感神经夹闭术是治疗FB和手掌/腋窝HH的一种安全有效的方法。CS的发生率与标准交感神经切断术相似或更低，如有必要，该技术可通过移除夹子来逆转交感神经阻断。
