CAJ | 학술논문

目的回顾性总结经脐胸交感神经切断术(transumbilical thoracic sympathectomy,TTS)1年随访结果,评估采用TTS技术的手术效果.方法 2010年4月至2011年8月,38例手汗症患者接受经脐胸交感神经切断术,男17例,女21例;年龄14 ～35岁,平均22岁.单纯手汗22例,手汗合并腋汗16例.从治愈率、疼痛持续时间、术后满意率以及并发症发生率等方面进行随访.结果 38例手术均成功完成,手术40 ～86 min,平均47 min;术中无严重并发症发生.35例随访1.0～1.6年,平均1,2年.所有手汗症均达到临床治愈,腋汗治愈率81.3％(13/16例),总复发1例(2.9％);代偿性出汗10例(28.6％),气胸2例(5.7％),刀口疼痛平均持续时间2天;无霍纳综合征、膈疝等并发症发生.结论经脐内镜下胸部交感神经切断术治疗手汗症安全、可行,远期疗效稳定,可为部分人群提供新的手术入路选择.
목적 회고성총결경제흉교감신경절단술(transumbilical thoracic sympathectomy,TTS)1년수방결과,평고채용TTS기술적수술효과.방법 2010년4월지2011년8월,38례수한증환자접수경제흉교감신경절단술,남17례,녀21례;년령14 ～35세,평균22세.단순수한22례,수한합병액한16례.종치유솔、동통지속시간、술후만의솔이급병발증발생솔등방면진행수방.결과 38례수술균성공완성,수술40 ～86 min,평균47 min;술중무엄중병발증발생.35례수방1.0～1.6년,평균1,2년.소유수한증균체도림상치유,액한치유솔81.3％(13/16례),총복발1례(2.9％);대상성출한10례(28.6％),기흉2례(5.7％),도구동통평균지속시간2천;무곽납종합정、격산등병발증발생.결론 경제내경하흉부교감신경절단술치료수한증안전、가행,원기료효은정,가위부분인군제공신적수술입로선택.
Objective To summarize the one year follow-up clinical result of patients undergoing endoscopic transumbilical thoracic sympathectomy and to assess the related factors influencing the outcome.Methods A total of 38 patients (17 males,22 females) with a mean age of 22 years old underweut transumbilical thoracic sympathectomy from April 2010 to August 2011.Of these,16 patients suffered concomitant palmar and axillary hyperhidrosis and 22 palmar hyperhydrosis alone.The following parameters were evaluated:clinical improvement,satisfaction,changes in quality of life,and compensatory sweating and gustatory sweating.Results The operation was aceomplished successfully in all 38 patents with a mean operation time of 47 min (40-86 min).35 patients were followed up for 1.0-1.6years (mean 1.2 years).The rate of palmar hyperhidrosis (PH) and axillary hyperhidrosis (AH) resolution was 100％ and 81.3％,respectively,and recurred in 1 patient.Postoperative complications were noticed in 12 patients,including compensatory sweating in 10 cases and pneomothorax in 2 cases.The post-operative pain lasts less than 2 days in all patients.There was no Horner syndrome and no diaphragmatic hernia was observed.Conclusion Endoscopic transumbilical thoracic sympathectomy is a safe and efficacious alternative to the conventional approach.