Shalaby Mohamed Sameh, El-Shafee Ehab, Safoury Hesham, El Hay Sameh Abd
Ain Shams University, Cairo, Egypt.
Pediatr Surg Int. 2012 Mar;28(3):245-8. doi: 10.1007/s00383-011-2984-3. Epub 2011 Sep 30.
Thoracoscopic sympathectomy (TS) is an effective treatment for hyperhidrosis. Various surgical approaches are described in the literature. We describe the technique of thoracoscopic excision of the sympathetic chain done exclusively in children younger than 13 years.
All patients younger than 13 years who underwent TS from 2006 at a single institution were prospectively identified and fully evaluated with emphasis on demographic data, age, surgical management, complications and follow-up. All patients were contacted again at the end of 2009 to complete a follow-up questionnaire.
Twelve patients underwent TS between 2006 and 2009. Age ranged from 6 to 13 years. This involved T2-T3 excision for nine patients with isolated palmar hyperhidrosis, and T2-T3-T4 excision for three with additional axillary hyperhidrosis. Six underwent bilateral TS at the same session and six underwent unilateral TS for the dominant side. Four of them had their contralateral operation performed 2-3 months later. Dry limbs were immediately achieved in all patients. Compensatory sweating (CS) was noted in eight patients. Complications included transient ptosis in two and mild recurrence in one.
Thoracoscopic excision of the sympathetic chain is a simple and safe procedure that relieves hyperhidrosis in all cases and significantly improves the quality of life.
胸腔镜交感神经切除术（TS）是治疗多汗症的有效方法。文献中描述了各种手术方法。我们描述了仅在13岁以下儿童中进行的胸腔镜交感神经链切除术技术。
前瞻性确定并全面评估了2006年起在单一机构接受TS治疗的所有13岁以下患者，重点关注人口统计学数据、年龄、手术管理、并发症和随访情况。2009年底再次联系所有患者，以完成一份随访问卷。
2006年至2009年间，12例患者接受了TS治疗。年龄范围为6至13岁。其中9例单纯手掌多汗症患者接受了T2-T3切除，3例伴有腋窝多汗症的患者接受了T2-T3-T4切除。6例在同一次手术中接受了双侧TS，6例对优势侧进行了单侧TS。其中4例在2至3个月后进行了对侧手术。所有患者术后肢体立即变干。8例患者出现代偿性出汗（CS）。并发症包括2例短暂性上睑下垂和1例轻度复发。
胸腔镜交感神经链切除术是一种简单安全的手术，可在所有病例中缓解多汗症，并显著提高生活质量。
