Nüesch B, Ammann J, Hess P, Lüdin A
Chirurgische Klinik, Thurgauer Kantonsspital Münsterlingen.
Swiss Surg. 1996(3):112-5.
Between 1976 and 1994 we performed 26 thoracic sympathectomies for treatment of therapy-resistant palmar hyperhidrosis. Until the end of 1992 the operation was performed using an open transaxillary approach, since 1993 sympathectomy was done by video-assisted thoracoscopy. Both procedures consisted in excision of the thoracic ganglia T2 to T5. The only complication was a pneumothorax in the open surgery group (successfully treated by drainage). Compensatory sweating occurred in 70% of our patients, compared to results in the literature of 60-90%. We did not note further complications, e.g. no Horner's syndrome. All of our patients were satisfied with the result of the operation. Comparison of the two collectives shows significant advantages for video-assisted thoracoscopic surgery. the procedure is easier to perform, exposure is better, cosmetic results are favourable, operation-time and hospital stay are reduced.
1976年至1994年间,我们实施了26例胸交感神经切除术,用于治疗难治性手掌多汗症。1992年底前,手术采用开放性经腋窝入路,自1993年起,交感神经切除术通过电视辅助胸腔镜进行。两种手术均包括切除胸2至胸5神经节。唯一的并发症是开放手术组出现气胸(通过引流成功治疗)。我们70%的患者出现代偿性出汗,相比之下,文献报道的发生率为60%-90%。我们未发现其他并发症,如霍纳综合征。所有患者对手术结果均满意。两组对比显示,电视辅助胸腔镜手术具有显著优势。该手术操作更简便,视野更好,美容效果良好,手术时间和住院时间缩短。