胸腔镜下T3胸交感神经切断术治疗手汗症62例临床分析

目的探讨胸腔镜下T3胸交感神经切断术治疗手汗症的疗效。方法 2008年7月～2011年3月对62例手汗症行胸腔镜下经操作孔电凝钩切断T3胸交感神经及可能存在的交通支。结果 62例手术均获成功,手术时间(双侧)19～36 min,平均24.3 min。住院3～6 d,平均4.5 d。术后出现胸腔积液9例,4例行胸腔穿刺抽液,5例经保守治疗治愈。56例术后随访3～12个月,平均7.2月,2例复发轻度手汗,3例出现轻度代偿性出汗。结论胸腔镜下T3胸交感神经切断术治疗手汗症疗效确切,不易复发,术后代偿性多汗发生率低,安全性高。

Thoracoscopic T3 Sympathectomy for Palmar Hyperhidrosis: Analysis on 62 Cases

Objective To discuss and analyze our clinical experience on thoracoscopic T3 sympathectomy for palmar hyperhidrosis.Methods From July 2008 to March 2011,we performed thoracoscopic T3 sympathectomy on totally 62 patients with palmar hyperhidrosis.With incisions made at the 5th intercostal space on the midaxillary line,and 3rd intercostal space on the anterior axillary line as observation and operation holes,respectively,we cut the thoracic sympathetic chain and communicating branches.Results The procedure was completed successfully on all the 62 patients.The mean operation time for bilateral procedure was 24.3 minutes(19-36 minutes),and mean hospital stay was 4.5 days(3-6 days).Nine patients developed postoperative pleural effusion but were all cured afterwards.Totally 56 patients received follow-up for 3-12 months with a mean of 7.2 months,during which,2 patients showed recurrent mild palmar hyperhidrosis and 3 patients had mild compensatory sweating.Conclusion Thoracoscopic T3 sympathectomy is an effective,minimally invasive and safe therapy for palmar hyperhidrosis with a low recurrence rate.