Kravarusic Dragan, Freud Enrique
Department of Pediatric Surgery, Schneider Children's Medical Center of Israel, Rabin Measical Center, Petach Tikva, Israel.
Afr J Paediatr Surg. 2012 May-Aug;9(2):143-7. doi: 10.4103/0189-6725.99402.
Hyperhidrosis can cause significant professional and social handicaps. Surgery is the preferred treatment modality for hyperhidrosis. There has been evolution in the surgical management of hyperhidrosis. This study evaluated the place of minimally invasive surgical approach and its long-term outcome in the management of hyperhidrosis.
A 10-year prospective study of all children and adolescents who underwent thorascopic sympathectomy at the Schneider Children's Hospital of Israel. Data were validated for the procedure and analysed for outcome of procedure.
There were 148 patients, 66 were males and 82 were females, with a median age of 13.8 SD ± 4.0 years. Two hundred and ninety-six thoracopic sympathectomies were performed with no conversion to open procedure. The mean operation time was 18 min. Ninety-five per cent of the patients were discharged the next day with a mean hospital stay of 1.2 days. Postoperative complications included segmental atelectasis in seven (4.72%) patients, pneumothorax in two (1.35%) and transient unilateral Horner's syndrome in one (0.67%). Seventy-one (38.8%) experienced some form of compensatory hyperhidrosis. Complete relief of palmer hyperdidrosis was achieved in all patients (mean follow-up = 5.03 ± 1.76 years). The outcome was very satisfactory in 91 (61.5%) and satisfactory in 48 (32.4%). Only nine (6.1%) were not satisfied with the outcome.
Thorascopic sympathectomy provides effective and satisfactory cure for palmer hyperhidrosis with acceptable complication rate and excellent satisfactory outcome. There is a possibility of compensatory sweating in some individuals.
多汗症会导致严重的职业和社交障碍。手术是多汗症的首选治疗方式。多汗症的手术治疗方法不断演变。本研究评估了微创手术方法在多汗症治疗中的地位及其长期疗效。
对在以色列施耐德儿童医院接受胸腔镜交感神经切除术的所有儿童和青少年进行了一项为期10年的前瞻性研究。对手术数据进行验证，并分析手术结果。
共有148例患者，其中男性66例，女性82例，中位年龄为13.8岁±4.0标准差。共进行了296例胸腔镜交感神经切除术，无一例转为开放手术。平均手术时间为18分钟。95%的患者在第二天出院，平均住院时间为1.2天。术后并发症包括7例（4.72%）节段性肺不张、2例（1.35%）气胸和1例（0.67%）短暂性单侧霍纳综合征。71例（38.8%）出现某种形式的代偿性多汗。所有患者手掌多汗症均完全缓解（平均随访时间=5.03±1.76年）。91例（61.5%）结果非常满意，48例（32.4%）满意。只有9例（6.1%）对结果不满意。
胸腔镜交感神经切除术能有效且令人满意地治愈手掌多汗症，并发症发生率可接受，满意度高。部分个体有可能出现代偿性出汗。
