Turk J Med Sci. 2015;45(4):771-4. doi: 10.3906/sag-1405-51.
BACKGROUND/AIM: The goal of this retrospective study was to evaluate the outcomes and complications of bilateral videothoracoscopic sympathicotomy without using single-lung ventilation in the treatment of primary hyperhidrosis and facial blushing.
We retrospectively reviewed 154 consecutive patients (70 females and 84 males) who underwent bilateral sympathicotomy for palmar, axillary, and facial/scalp hyperhidrosis or facial blushing from February 2005 to June 2013. The patients were intubated with single-lumen endotracheal tube, and then sympathicotomies were performed via videothoracoscopy during controlled apnea periods.
Sympathicotomies were performed at costal levels 2, 3, and 4. No perioperative mortality or conversion to open surgery was recorded. Mean operation time was 31.2 ± 2.4 min and mean hospital stay was 1.1 ± 0.6 days. One patient experienced a unilateral pneumothorax that required treatment. There were no abnormal hemodynamic parameters measured during the perioperative apnea periods. The long term follow-up period was 21.4 ± 5 months. Twenty-nine cases (18.8%) were complicated by compensatory sweating. No recurrence was observed during the follow-up period.
Video-assisted thoracoscopic sympathicotomy without lung isolation provides effective cure of primary hyperhidrosis and facial blushing. This procedure can shorten the operative time without any aberrant hemodynamic shifts.
背景/目的：本回顾性研究旨在评估双侧胸腔镜交感神经切断术（不使用单肺通气）治疗原发性多汗症和面部潮红的效果和并发症。
我们回顾性分析了 2005 年 2 月至 2013 年 6 月期间因手掌、腋窝和面部/头皮多汗症或面部潮红而行双侧交感神经切断术的 154 例连续患者（70 名女性和 84 名男性）。患者使用单腔气管内导管插管，然后在控制呼吸暂停期间通过胸腔镜进行交感神经切断术。
交感神经切断术在第 2、3 和 4 肋进行。无围手术期死亡或转为开放手术。平均手术时间为 31.2±2.4 分钟，平均住院时间为 1.1±0.6 天。1 例患者出现单侧气胸，需要治疗。在围手术期呼吸暂停期间未测量到异常的血液动力学参数。长期随访期为 21.4±5 个月。29 例（18.8%）出现代偿性出汗。随访期间无复发。
不使用肺隔离的电视胸腔镜交感神经切断术可有效治疗原发性多汗症和面部潮红。该手术可缩短手术时间，且不会引起血液动力学异常。
