Noppen M, Vincken W, Dhaese J, Herregodts P, D'haens J
Respiratory Division, Academic Hospital AZ-VUB, Vrije Universiteit Brussel, Belgium.
Acta Clin Belg. 1996;51(4):244-53. doi: 10.1080/22953337.1996.11718517.
Various treatments for essential hyperhidrosis are available. The aim of this study is to present our experience with a simplified thoracoscopic sympathicolysis technique in this disorder, and to confront our results with data in the literature, 35 consecutive patients (11 male, 24 female, age 12-44 years) with essential hyperhidrosis, refractory to "conventional" medical treatment presenting between August 1993 and May 1994 were studied. Bilateral D2-D3 sympathicolysis was performed using a simplified one-time bilateral thoracoscopic procedure under general anaesthesia. Clinical scores, complications and side effects were recorded one week, one month and one year after the intervention. Severe hyperhidrosis was present in the hands in 100%, axillae in 66% and soles of the feet in 86% of patients. In one patient, only a unilateral intervention was possible due to pleural adhesions. In the other 34 patients, palmar hyperhidrosis was completely and permanently relieved in 100% of cases. Axillar hyperhidrosis was significantly improved after one year in 91% of patients, 52% of which showed a complete disappearance of hyperhidrosis. Side effects and complications were minimal. There were no permanent pleural, neurological (Horner) or other sequellae. Patient satisfaction was invariably very high. These findings compare favourably with historical data in the literature.
目前有多种治疗原发性多汗症的方法。本研究的目的是介绍我们在这种疾病中使用简化胸腔镜交感神经切断术的经验，并将我们的结果与文献数据进行对比。我们对1993年8月至1994年5月期间连续收治的35例（男11例，女24例，年龄12 - 44岁）原发性多汗症患者进行了研究，这些患者对“传统”药物治疗无效。在全身麻醉下，采用简化的一次性双侧胸腔镜手术进行双侧D2 - D3交感神经切断术。在干预后1周、1个月和1年记录临床评分、并发症和副作用。100%的患者双手存在重度多汗症，66%的患者腋窝多汗，86%的患者足底多汗。1例患者因胸膜粘连仅能进行单侧干预。在其他34例患者中，100%的病例手掌多汗症完全且永久缓解。91%的患者在1年后腋窝多汗症有显著改善，其中52%的患者多汗症完全消失。副作用和并发症极少。没有永久性胸膜、神经（霍纳氏综合征）或其他后遗症。患者满意度始终非常高。这些结果与文献中的历史数据相比具有优势。
