Demirkaya Ahmet, Erşen Ezel, Kılıç Burcu, Kara Hasan Volkan, İşcan Mehlika, Kaynak Kamil, Turna Akif
Department of Thoracic Surgery, School of Medicine, Istanbul Acıbadem University, Istanbul, Turkey.
Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
Wideochir Inne Tech Maloinwazyjne. 2016;11(2):88-93. doi: 10.5114/wiitm.2016.60182. Epub 2016 May 25.
The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis.
To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.
Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis. The level of sympathicotomy was T2 in 2 (2.2%) patients, T2 to T3 in 31 (33%) patients, T2 to T4 in 46 (50%) patients and T3 to T4 in 12 (13%) patients. Demographic data, length of postoperative stay, substitution index (SI), admission rate (AR) and readmission rate (RR), complications and patient satisfaction were reviewed retrospectively.
Two (2.2%) patients suffered from chest pain, while 4 (4.3%) patients complained about pain at the port site. Mean discharge time after surgery was 5.1 h (range: 4-6 h), mean duration of hospital stay was 0.15 days (0-3 days) postoperatively and the mean operation time was 43.6 min (15-130 min). In 8 (8.6%) patients, pneumothorax was detected on postoperative chest X-ray, while 5 (5.4%) patients required chest tube drainage. Mild or moderate compensatory sweating developed in 32 (34.7%) patients. No recurrence was observed, and the satisfaction rate was 96.7%. Substitution index and admission rate were 91.3% and 11% respectively, while RR was 0%.
Bilateral video-assisted thoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.
电视胸腔镜手术是一种微创手术，具有术后疼痛较轻和住院时间较短等优点。它也是一种安全的手术，可在门诊进行。
确定电视胸腔镜交感神经切断术是否能在大多数患者中作为门诊手术安全地进行。
2005年7月至2015年10月期间，共有92例患者在我科门诊接受了双侧单孔胸腔镜交感神经切断术。交感神经切断的水平为T2的患者有2例（2.2%），T2至T3的患者有31例（33%），T2至T4的患者有46例（50%），T3至T4的患者有12例（13%）。回顾性分析患者的人口统计学数据、术后住院时间、替代指数（SI）、入院率（AR）和再入院率（RR）、并发症及患者满意度。
2例（2.2%）患者出现胸痛，4例（4.3%）患者主诉切口部位疼痛。术后平均出院时间为5.1小时（范围：4 - 6小时），术后平均住院时间为0.15天（0 - 3天），平均手术时间为43.6分钟（15 - 130分钟）。8例（8.6%）患者术后胸部X线检查发现气胸，5例（5.4%）患者需要胸腔闭式引流。32例（34.7%）患者出现轻或中度代偿性多汗。未观察到复发情况，满意度为96.7%。替代指数和入院率分别为91.3%和11%，而再入院率为0%。
双侧电视辅助胸腔镜交感神经切断术可在大多数患者中作为门诊手术安全地进行。
