Rieger R, Pedevilla S, Pöchlauer S
Department of Surgery, Landeskrankenhaus Gmunden, Miller von Aichholzstrasse 49, 4810 Gmunden, Austria.
Br J Surg. 2009 Dec;96(12):1422-8. doi: 10.1002/bjs.6729.
The aim of this study was to evaluate the results of endoscopic lumbar sympathectomy for plantar hyperhidrosis.
A total of 178 endoscopic resections of the lower sympathetic lumbar trunk were carried out in 90 patients (59 men, 31 women) with severe plantar hyperhidrosis. The clinical results, including morbidity and satisfaction rates, were evaluated. Follow-up examination was carried out for all patients after a mean follow-up of 24 (range 3-45) months.
All procedures were carried out endoscopically. There were no deaths and only three patients had a postoperative complication. All patients had evidence of postoperative sympathetic denervation of the feet. In 87 patients (97 per cent) hyperhidrosis was eliminated, but in three (3 per cent) it recurred. Compensatory sweating occurred in 40 patients (44 per cent), postsympathectomy neuralgia in 38 (42 per cent) and one man suffered temporary loss of ejaculation. A total of 86 patients (96 per cent) were very, or partly, satisfied with the result, and 83 (92 per cent) would have the procedure repeated if required.
Endoscopic lumbar sympathectomy was a safe and effective option for patients with severe plantar hyperhidrosis.
本研究旨在评估内镜下腰交感神经切除术治疗足底多汗症的效果。
对90例（59例男性，31例女性）重度足底多汗症患者共进行了178次内镜下腰交感神经干切除术。评估临床结果，包括发病率和满意率。对所有患者进行了平均24个月（范围3 - 45个月）的随访检查。
所有手术均在内镜下完成。无死亡病例，仅3例患者出现术后并发症。所有患者均有足部术后交感神经去神经支配的证据。87例患者（97%）多汗症得以消除，但3例（3%）复发。40例患者（44%）出现代偿性出汗，38例（42%）出现交感神经切除术后神经痛，1例男性出现暂时性射精障碍。共有86例患者（96%）对结果非常满意或部分满意，83例（92%）表示如有需要愿意再次接受该手术。
内镜下腰交感神经切除术对于重度足底多汗症患者是一种安全有效的选择。
