Graham A N, Owens W A, McGuigan J A
Regional Thoracic Surgery Department, Royal Victoria Hospital, Belfast UK.
J R Coll Surg Edinb. 1996 Jun;41(3):160-3.
Transthoracic endoscopic electrocautery of the sympathetic chain is increasingly being used as a technique for producing the effects of upper thoracic sympathectomy. In November 1990 we introduced this operation as a regional service in Northern Ireland and have assessed the results in patients with idiopathic hyperhidrosis of the palms and axillae. There were 92 sympathectomics carried out for hyperhidrosis on 47 patients between 26 November 1990 and 6 September 1993. Full follow-up was possible in 45 patients (96%) at a median of 13 months (range 3-36) after the operation. Symptoms were improved in 43 patients (96%) at review. In three patients surgery failed to control symptoms on one side, and in two there was bilateral recurrence at 4 and 8 months after initial good results. Compensatory hyperhidrosis occurred in 35 patients (56%) and was severe in 4 (9%). Nine of 34 patients (34%) with plantar symptoms reported improvement in these post-operatively. This paper, with its high level of full follow-up, confirms thoracoscopic sympathectomy to be effective treatment for both palmar and axillary hyperhidrosis. Patient selection, however, is important and the risk of compensatory hyperhidrosis must be fully explained.
经胸交感神经链内镜电灼术越来越多地被用作一种产生上胸交感神经切除术效果的技术。1990年11月，我们在北爱尔兰将此手术作为一项区域服务引入，并对患有手掌和腋窝特发性多汗症的患者的结果进行了评估。在1990年11月26日至1993年9月6日期间，对47例患者进行了92次多汗症交感神经切除术。术后中位13个月（范围3 - 36个月）时，45例患者（96%）实现了全面随访。复查时43例患者（96%）症状得到改善。3例患者手术未能控制一侧症状，2例患者在最初效果良好后4个月和8个月出现双侧复发。35例患者（56%）发生代偿性多汗症，其中4例（9%）较为严重。34例有足底症状的患者中有9例（34%）报告术后这些症状有所改善。本文全面随访水平较高，证实胸腔镜交感神经切除术是治疗手掌和腋窝多汗症的有效方法。然而，患者选择很重要，必须充分解释代偿性多汗症的风险。
