胸腔镜单孔隐蔽切口治疗手汗症30例

目的探讨胸腔镜单孔隐蔽切口手术治疗手汗症的可行性和安全性。方法回顾性分析2012年1月～2013年2月我院30例胸腔镜单孔隐蔽切口手术治疗手汗症的临床资料。对男性患者采取经乳晕弧形切口，女性患者采取第3肋间乳腺外缘腋下小切口，行R3（riblevels）胸腔镜交感神经链切断术（endoscopic thoracic sympathectomy，ETS）。结果均顺利完成胸腔镜手术。随访时间1～14个月，平均8．2月，其中7例〉12个月。术后手汗均消失，4例（13．3％）轻度代偿性多汗，无需进一步治疗，术后2个月好转。无霍纳综合征。术后切口隐蔽，瘢痕不明显，患者满意。结论胸腔镜下胸交感神经链切断术是目前治疗手汗症的安全、微创、有效的方法，隐蔽切口更能进一步满足患者的美容要求，增加患者对手术的满意度。

Single-port Hidden Incision Endoscopic Thoracic Sympathectomy for Palmar Hyperhidrosis

Objective To explore the feasibility and safety of single-port hidden incision endoscopic thoracic sympathectomy （ETS） for palmar hyperhidrosis. Methods We retrospectively analyzed the clinical data of 30 patients undergoing one-port hidden incision VATS between January 2012 and February 2013. All patients underwent R3 （rib levels） endoscopic thoracic sympathectomy through mammary areola for male patients and through the edge of mammary in the 3rd intercostal for female patients. Results All the 30 surgeries were completed successfully. All the cases were followed up for 1 - 14 months （average, 8.2 months） , including 7 cases being followed up for more than 12 months. The follow-up showed improvement of palmar hyperhidrosis （effective rate, 100% ）. Four cases （ 13.3% ） suffered from mild compensatory sweating and recovered 2 months after the surgery without further treatment. No Horner＇ s syndrome occurred. Surgical incision and scars were not obvious and patients were satisfied with the surgical results. Conclusion ETS with hidden incision is a safe, minimally invasive and feasible technique, which can improve the cosmetic effect of the surgery.