Wait Scott D, Killory Brendan D, Lekovic Gregory P, Dickman Curtis A
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
J Neurosurg Pediatr. 2010 Aug;6(2):183-7. doi: 10.3171/2010.5.PEDS09225.
Palmar, axillary, and plantar hyperhidrosis is often socially, emotionally, and physically disabling for adolescents. The authors report surgical outcomes in all adolescents treated for palmar hyperhidrosis via bilateral thoracoscopic sympathectomy at the Barrow Neurological Institute by the senior author.
A prospectively maintained database of all adolescent patients undergoing bilateral thoracoscopic sympathectomy between 1998 and 2006 (inclusive) was reviewed. Additional follow-up was obtained as needed in clinic or by phone or written questionnaire.
Fifty-four patients (40 females) undergoing bilateral procedures were identified. Their mean age was 15.4 years (range 10-17 years). Average follow-up was 42 weeks (range 0.2-143 weeks). Hyperhidrosis involved the palms alone in 10 patients; the palms and axilla in 6 patients; the palms and plantar surfaces in 17 patients; and the palms, axilla, and plantar surfaces in 21 patients. Palmar hyperhidrosis resolved completely in 98.1% of the patients. Resolution or improvement of symptoms was seen in 96.3% of patients with axillary and 71.1% of those with plantar hyperhidrosis. Hospital stay averaged 0.37 days with 68.5% of patients discharged the day of surgery. One patient experienced brief intraoperative asystole that resolved with medications and had no long-term sequelae. Otherwise, no serious intraoperative complications occurred. No patient required chest tube drainage. The percentage of patients who reported satisfaction and willingness to undergo the procedure again was 98.1%.
Biportal, bilateral thoracoscopic sympathectomy is an effective and low-morbidity treatment for severe palmar, axillary, and plantar hyperhidrosis.
手掌、腋窝及足底多汗症常给青少年带来社交、情感及身体上的困扰。作者报告了由资深作者在巴罗神经学研究所为所有接受双侧胸腔镜交感神经切除术治疗手掌多汗症的青少年患者的手术结果。
回顾了1998年至2006年（含）期间所有接受双侧胸腔镜交感神经切除术的青少年患者的前瞻性维护数据库。根据需要在诊所、通过电话或书面问卷进行了额外随访。
确定了54例接受双侧手术的患者（40例女性）。他们的平均年龄为15.4岁（范围10 - 17岁）。平均随访时间为42周（范围0.2 - 143周）。多汗症仅累及手掌的有10例患者；累及手掌和腋窝的有6例患者；累及手掌和足底的有17例患者；累及手掌、腋窝和足底的有21例患者。98.1%的患者手掌多汗症完全缓解。腋窝多汗症患者中96.3%症状缓解或改善，足底多汗症患者中71.1%症状缓解或改善。平均住院时间为0.37天，68.5%的患者在手术当天出院。1例患者术中出现短暂心脏停搏，经药物治疗后缓解，无长期后遗症。此外，未发生严重术中并发症。无一例患者需要胸腔闭式引流。报告满意并愿意再次接受该手术的患者比例为98.1%。
双孔双侧胸腔镜交感神经切除术是治疗严重手掌、腋窝及足底多汗症的一种有效且低发病率的治疗方法。
