胸腔镜经乳晕单切口胸交感神经切断术治疗手汗症

目的 探讨经乳晕胸腔镜下胸交感神经切断术(Endoscopic Thoracic Sympathicotomy,ETS)的安全性、可行性及美容效果.方法 自2011年1-7月,我们三所医院(福建医科大学附属第一医院、厦门大学附属中山医院、福州市第一医院)采用经乳晕单切口为52例(男45例,女7例)手汗症患者成功施行ETS.结果 全组患者一侧手术时间(指切皮至术毕)5～8 min,平均6min,住院时间2～3d,平均2.2d,无一例手术中转开胸或发生术中术后并发症.全组随访1～7个月,平均2.8个月,切口处未见明显瘢痕,乳头及乳晕外形无变化且感觉功能良好.所有患者均十分满意手术疗效和美容效果.结论 采用经乳晕单切口路径施行ETS安全可行和有效、切口隐蔽,未见明显瘢痕,符合美容最佳需求,是治疗手汗症又一种可供患者选择的隐痕微创手术路径,推广应用前景广阔.

Trans-areola single port endoscopic thoracic sympathectomy for the treatment of palmar hyperhidrosis: a new surgical approach

Objective To evaluate the cosmetic effects and safety profiles of trans-areola single port endoscopic thoracic sympathectomy.Methods A retrospective study was conducted for 45 males and 7 females with palmar hyperhidrosis undergoing trans-areola single port endoscopic thoracic bilateral sympathectomy during April and June 2011. Results All operations were successfully performed without severe morbidity and mortality. No conversion to open technique was necessary. The mean unilateral operative duration was 6 minutes ( range:5-8).The time was calculated from the time of skin incision to that of dressing application over wound.The mean hospitalization duration was 2.2 days ( range:2-3 ).The mean follow-up period was 2.8 months ( range:1-7).All patients achieved excellent cosmetic effects.No incision scar was found.Conclusion Trans-areola single port endoscopic thoracic sympathectomy is a safe and effective therapeutic procedure for primary palmar hyperhidrosis.The incision is undetectable with excellent cosmetic effects. The trans-areola route is a new ideal and promising approach for endoscopic thoracic sympathectomy.