与原发性手掌多汗症相关的足底多汗症：电视辅助胸腔镜交感神经切除术的结果。

Plantar hyperhidrosis associated with primary palmar hyperhidrosis: Outcome following video-assisted thoracoscopic sympathectomy.

机构信息

Cardiothoracic Surgery Department, Faculty of Medicine of Alexandria, Alexandria, Egypt.

出版信息

Asian Cardiovasc Thorac Ann. 2021 May;29(4):310-317. doi: 10.1177/0218492321996508. Epub 2021 Feb 20.

DOI:10.1177/0218492321996508

PMID:33611949

Abstract

INTRODUCTION

Primary palmar hyperhidrosis is an abnormal over-sweating of palms. It is usually associated with plantar hyperhidrosis. Video-assisted thoracoscopic sympathectomy is the treatment of choice for palmar hyperhidrosis; however, it may affect plantar hyperhidrosis.

OBJECTIVES

The aim of this study was to evaluate the effect of thoracoscopic sympathectomy on plantar hyperhidrosis.

METHODS

This prospective study included patients who presented to the Cardiothoracic Surgery Department with primary palmo-planter hyperhidrosis and received thoracoscopic sympathectomy between January 2014 and December 2018. Preoperatively, patients scored subjectively the degree of palmar and plantar hyperhidrosis on Visual Analogue Scale. Following surgery, scoring was performed at three intervals: 7, 30, and 180 days. Presence of compensatory sweating and its scoring was obtained at the same intervals. Complications and patient satisfaction were recorded.

RESULTS

A total of 518 patients were included. Complication rate, excluding compensatory hyperhidrosis, was 2.7%. Preoperative Visual Analogue Scale score for palmar hyperhidrosis was 9.9 ± 3.8 that following thoracoscopic sympathectomy decreased to 0.041 ± 0.2 on the seventh postoperative day. Further decrease to 0.3 ± 0.16 was noted on the 30th day and 180th day postoperatively. Preoperative Visual Analogue Scale score for plantar hyperhidrosis was 9.54 ± 0.66 that following sympathectomy decreased to 2.27 ± 1.67 on the seventh postoperative day. However, slight insignificant increase was noted to become 2.73 ± 1.65 on the 30th day and 6th month postoperatively. Compensatory hyperhidrosis was recorded in 3.9% of patients at 6th month postoperatively.

CONCLUSION

Palmar hyperhidrosis is usually associated with plantar hyperhidrosis. Thoracoscopic sympathectomy is an effective and safe treatment for palmar hyperhidrosis. It may completely or partially cure plantar hyperhidrosis.

摘要

引言

原发性手掌多汗症是手掌异常过度出汗。它通常与足底多汗症有关。胸腔镜交感神经切除术是治疗手掌多汗症的首选方法；然而，它可能会影响足底多汗症。

目的

本研究旨在评估胸腔镜交感神经切除术对足底多汗症的影响。

方法

本前瞻性研究纳入了 2014 年 1 月至 2018 年 12 月期间因原发性手掌-足底多汗症就诊于心胸外科并接受胸腔镜交感神经切除术的患者。术前，患者用视觉模拟量表主观评分手掌和足底多汗症的程度。术后，在 7、30 和 180 天进行评分。同时获得代偿性出汗及其评分。记录并发症和患者满意度。

结果

共纳入 518 例患者。排除代偿性多汗症后，并发症发生率为 2.7%。术前手掌多汗症的视觉模拟量表评分为 9.9±3.8，胸腔镜交感神经切除术后第 7 天降至 0.041±0.2。术后第 30 天和第 180 天分别降至 0.3±0.16。术前足底多汗症的视觉模拟量表评分为 9.54±0.66，交感神经切除术后第 7 天降至 2.27±1.67。然而，第 30 天和第 6 个月略有轻微升高，分别为 2.73±1.65。术后 6 个月有 3.9%的患者出现代偿性多汗症。