Kim Jae-Bum, Park Chang-Kwon, Kum Dong-Yoon
Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, College of Medicine, Keimyung University, Korea.
Korean J Thorac Cardiovasc Surg. 2011 Apr;44(2):154-8. doi: 10.5090/kjtcs.2011.44.2.154. Epub 2011 Apr 14.
Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis.
From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence.
There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002).
R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.
电视辅助胸交感神经切断术对原发性多汗症的治疗具有重要作用。患者在术后早期通常对手术效果满意，但在术后晚期会出现复发和代偿性出汗。有多种交感神经切断术方法可将复发和代偿性出汗降至最低。我们比较了第三肋（R3）以上和第四肋（R4）水平交感神经切断术在症状、满意度、复发以及手掌和腋窝代偿性多汗方面的效果。
1999年1月至2009年4月，对39例接受第三肋（R3）胸腔镜交感神经切断术治疗手掌和腋窝多汗症的患者以及94例接受第四肋（R4）胸腔镜交感神经切断术的患者，比较其术后早期和晚期的满意度、代偿性出汗及复发情况。
两组在性别和年龄上无差异。R3组和R4组的早期满意度分别为94.9%和98.9%。两组在早期满意度（R3组为94.9%，R4组为98.9%）、晚期满意度（R3组为84.6%，R4组为89.4%）或复发率（R3组为17.9%，R4组为17.0%）方面无差异。在代偿性出汗方面存在显著差异（R3组为71.8%，R4组为33%，p = 0.002）。
在治疗手掌和/或腋窝多汗症的代偿性出汗方面，与第三肋（R3）交感神经切断术相比，第四肋（R4）交感神经切断术显示出更好的疗效。
