Cohen Z, Shinhar D, Mordechai J, Mares A J
Dept. of Pediatric Surgery, Soroka Medical Center, Ben-Gurion University of the Negev, Beer Sheba.
Harefuah. 1996 Nov 1;131(9):303-5, 374.
We report our initial experience, over the past 3 years, with thoracoscopic sympathectomy for severe, primary, palmar hyperhidrosis in children and adolescents. From 1992-1995, 179 thoracoscopic sympathectomies were performed in 61 girls and 35 boys, 5.5 to 18 years old (mean 14.8). During the first 2 years the procedures were performed bilaterally but not simultaneously. During the past years, 65 underwent bilateral, simultaneous sympathectomy, using a single 10 mm subaxillary port of entry. 94 (98%) had immediate and permanent relief of palmar sweating. The immediate postoperative course was uneventful in all except 2 who had residual pneumothorax that required 24-hour intercostal drainage. These results compare favorably with the open method and are actually better in terms of less pain, early discharge, quicker return to normal activity and a smaller and less conspicuous scar. We emphasize the benefits of early surgery in children with severe, palmer hyperhidrosis, to avoid the many years of psychological, social and physical discomfort during adolescent growth and development.
我们报告了过去3年中，我们在儿童和青少年严重原发性掌部多汗症的胸腔镜交感神经切除术中的初步经验。1992年至1995年，对61名女孩和35名男孩进行了179例胸腔镜交感神经切除术，年龄在5.5至18岁之间（平均14.8岁）。最初两年手术是双侧进行但不同时进行。在过去几年中，65例采用单一10毫米腋下入口进行双侧同时交感神经切除术。94例（98%）掌部出汗立即得到永久性缓解。除2例有残留气胸需要进行24小时肋间引流外，所有患者术后即刻过程均顺利。这些结果与开放手术方法相比更具优势，实际上在疼痛减轻、早期出院、更快恢复正常活动以及疤痕更小且不明显方面表现更好。我们强调对于患有严重掌部多汗症的儿童早期手术的益处，以避免在青少年生长发育过程中出现多年的心理、社交和身体不适。
