Ersin Osman Emre, Yanik Fazli, Karamustafaoglu Yekta Altemur, Yoruk Yener
Department of Thoracic Surgery, Trakya University Faculty of Medicine, Edirne, Turkey.
J Minim Access Surg. 2025 Apr 1;21(2):175-182. doi: 10.4103/jmas.jmas_75_24. Epub 2024 Nov 29.
Pathologically excessive sweating in areas such as the palmar, axillary and/or plantar together with sympathetic hyperactivity that occurs independently of systemic causes is called primary hyperhidrosis. Although primary idiopathic hyperhidrosis can be seen at any age, the disease is most commonly seen in adolescents and young adults. The frequency of male and female genders is usually equal. Some medical and minimally invasive methods can be used in the treatment of primary hyperhidrosis. However, the known curative gold standard treatment method for the disease is thoracoscopic thoracic sympathectomy operation.
In this study, a total of 150 patients who applied to Trakya University Health Practice and Research Center, Department of Thoracic Surgery, between 15 October 2008 and 15 June 2021 and underwent thoracoscopic thoracic sympathectomy due to the diagnosis of hyperhidrosis were evaluated retrospectively. The patients were separated into two groups. Thoracoscopic thoracic sympathectomy was performed on the T2-T4 in the first group (Group I - n : 88) and on the T3-T5 sympathetic ganglions in the second group (Group II - n : 62).
The median age of patients included in the study was found to be 24 (20.75-28) years. Group I and Group II were similar in terms of gender characteristics, but Group II was older. Our success rate was found to be 92% ( n = 138). There was no mortality, major complication such as bleeding requiring open thoracotomy, chylothorax or Horner's syndrome in any of the patients. Minor complications were seen in the early and late period of the operation at a low rate. Our overall compensatory hyperhidrosis rate was 52% ( n = 78). Compensatory hyperhidrosis was detected more in Group I, although this was not statistically significant. We determined the overall satisfaction rate of our patients as 87.3% ( n = 133). The satisfaction rates of the patients in Group I and Group II were found to be similar.
Thoracoscopic thoracic sympathectomy is a fast, safe and minimally invasive treatment method with a low complication rate. More than 90% success and a significant increase in psychosocial condition and professional quality of life can be achieved with this procedure. Future studies are needed to reveal the relationship between operated ganglion levels and the development of compensatory hyperhidrosis.
手掌、腋窝和/或足底等部位出现病理性多汗，且伴有与全身病因无关的交感神经功能亢进，称为原发性多汗症。虽然原发性特发性多汗症在任何年龄都可能出现，但该疾病最常见于青少年和年轻人。男性和女性的发病率通常相等。原发性多汗症的治疗可采用一些医学和微创方法。然而，已知的该疾病的根治性金标准治疗方法是胸腔镜胸交感神经切除术。
本研究回顾性评估了2008年10月15日至2021年6月15日期间因多汗症诊断而在特拉凯大学健康实践与研究中心胸外科就诊并接受胸腔镜胸交感神经切除术的150例患者。患者分为两组。第一组（I组 - n：88）在T2 - T4水平进行胸腔镜胸交感神经切除术，第二组（II组 - n：62）在T3 - T5交感神经节进行手术。
研究纳入患者的中位年龄为24（20.75 - 28）岁。I组和II组在性别特征方面相似，但II组年龄更大。我们的成功率为92%（n = 138）。所有患者均未出现死亡、需要开胸手术的大出血、乳糜胸或霍纳综合征等严重并发症。手术早期和晚期均有较低发生率的轻微并发症。我们的总体代偿性多汗症发生率为52%（n = 78）。I组代偿性多汗症的检出率更高，尽管差异无统计学意义。我们确定患者的总体满意率为87.3%（n = 133）。I组和II组患者的满意率相似。
胸腔镜胸交感神经切除术是一种快速、安全且微创的治疗方法，并发症发生率低。该手术成功率超过90%，能显著改善心理社会状况和职业生活质量。未来需要进一步研究以揭示手术切除神经节水平与代偿性多汗症发生之间的关系。
