Yun Seok Won, Kim Yun Seok, Lee Yongjik, Lim Han Jung, Park Soon Ik, Jung Jong Pil, Park Chang Ryul
1 Dajung Chest Surgery , Suwon, Republic of Korea.
2 Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan , College of Medicine, Ulsan, Republic of Korea.
J Laparoendosc Adv Surg Tech A. 2017 Jan;27(1):36-42. doi: 10.1089/lap.2016.0387. Epub 2016 Sep 13.
There are many ways to treat focal hyperhidrosis, including surgeries for palmar and axillary hyperhidrosis. However, doctors and patients tend to be reluctant to perform surgery for plantar hyperhidrosis due to misconceptions and prejudices about surgical treatment. In addition, few studies have reported the outcome of surgeries for plantar hyperhidrosis. Therefore, the objective of this study was to determine the outcome (early and late postoperative satisfaction, complication, compensatory hyperhidrosis, recurrence rate, and efficiency) of surgical treatment for plantar hyperhidrosis.
From August 2014 to October 2015, lumbar sympathetic block (LSB) was performed in 82 patients with plantar hyperhidrosis using clipping method. Limited video-assisted LSB was performed using 5 mm ligamax-clip or 3 mm horizontal-clip after identifying L3-4 sympathetic ganglion through finger-touch and endoscopic vision.
Of the 82 patients, 45 were male and 37 were female. Their mean age was 26.38 years (range, 14-51 years). Mean follow-up time was 6.60 ± 3.56 months. Mean early postoperative satisfaction score was 9.6 on the 10th day postoperative evaluation. At more than 1 month later, the mean late postoperative satisfaction score was 9.2. There was no significant difference in early postoperative satisfaction score between clipping level L3 and L4/5. However, late postoperative satisfaction score was significantly better in the L3 group than that in the L4/5 group. Patient's age and body mass index did not affect the satisfaction score. However, male patients and patients who had history of hyperhidrosis operation showed higher satisfaction score than others.
Limited video-assisted LSB using clip provided good results with minimal complications and low compensatory hidrosis, contrary to the prejudice toward it. Therefore, surgical treatment is recommended for plantar hyperhidrosis.
治疗局限性多汗症有多种方法，包括针对手掌和腋窝多汗症的手术。然而，由于对手术治疗存在误解和偏见，医生和患者往往不愿对足底多汗症进行手术。此外，很少有研究报道足底多汗症手术的结果。因此，本研究的目的是确定足底多汗症手术治疗的结果（术后早期和晚期满意度、并发症、代偿性多汗症、复发率和疗效）。
2014年8月至2015年10月，采用夹闭法对82例足底多汗症患者进行腰交感神经阻滞（LSB）。通过手指触摸和内镜观察确定L3-4交感神经节后，使用5毫米ligamax夹或3毫米水平夹进行有限电视辅助LSB。
82例患者中，男性45例，女性37例。他们的平均年龄为26.38岁（范围14-51岁）。平均随访时间为6.60±3.56个月。术后第10天评估时，术后早期平均满意度评分为9.6分。1个月后，术后晚期平均满意度评分为9.2分。夹闭水平L3和L4/5之间的术后早期满意度评分无显著差异。然而，L3组的术后晚期满意度评分明显高于L4/5组。患者的年龄和体重指数不影响满意度评分。然而，男性患者和有多汗症手术史的患者的满意度评分高于其他患者。
与对其的偏见相反，使用夹子进行有限电视辅助LSB效果良好，并发症少，代偿性多汗症发生率低。因此，推荐对足底多汗症进行手术治疗。
