Kopelman D, Hashmonai M, Ehrenreich M, Assalia A
Department of Surgery B, Rambam Medical Center, and the Faculty of Medicine, Technion, Israel Institute of Technology, Haifa.
Surg Laparosc Endosc. 1998 Oct;8(5):370-5.
The aim of this study was to evaluate the learning curve of upper dorsal thoracoscopic sympathectomy. From June 1993 to December 1996, we performed 232 sympathectomies on 116 patients with primary palmar hyperhidrosis. The T2-T3 ganglia were resected by electrocuting and were removed for histologic examination. The series was divided into two groups of 58 patients each, and operations in each group occurred during a period of 21 months. Follow-up was obtained on 111 patients for a mean of 25.06+/-12.62 months. All limbs were dry after the operation, and hyperhidrosis did not recur. The anesthesia time was reduced, but the operating time, the difficulty in identifying and in resecting the ganglia, compensatory hyperhidrosis, postoperative neuralgia, and subjective satisfaction with the procedure were similar in both groups. The learning curve in the present study was mainly reflected by a reduction in the incidence of Horner's syndrome.
本研究的目的是评估上胸段胸腔镜交感神经切除术的学习曲线。1993年6月至1996年12月，我们对116例原发性手掌多汗症患者进行了232例交感神经切除术。通过电切切除T2-T3神经节，并将其取出进行组织学检查。该系列患者分为两组，每组58例，每组手术时间为21个月。对111例患者进行了随访，平均随访时间为25.06±12.62个月。术后所有肢体均干燥，多汗症未复发。麻醉时间缩短，但两组的手术时间、神经节识别和切除难度、代偿性多汗症、术后神经痛以及患者对手术的主观满意度相似。本研究中的学习曲线主要表现为霍纳综合征发生率的降低。
