经腋窝隐痕单切口胸腔镜下胸交感神经切断术治疗手汗症  

Transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis： a novel surgical approach

作　　者：林敏[1] 涂远荣[1] 赖繁彩[1] 李旭[1] 陈剑锋[1] 罗荣刚[1] 林剑波[1] 

机构地区：[1]福建医科大学附属第一医院胸外科,福州350005

出　　处：《中华医学杂志》2013年第41期3300-3301,共2页National Medical Journal of China

基　　金：国家自然科学基金（81070906）;福建医科大学重大科研基金（2009ZD016）

摘　　要：目的探讨经腋窝隐痕单切口胸腔镜下胸交感神经切断术（ETS）治疗手汗症的安全性、可行性及美容效果。方法自2009年1月至2012年3月，福建医科大学附属第一医院胸外科326例手汗症患者均采用经腋窝隐痕单切口成功施行ETS，切口长约0．5cm，切口仅做皮下缝合，采用美国强生公司生产Dermabond皮肤黏合剂黏合皮肤。结果全组患者一侧手术时间（指切皮至黏合切口）5—8min，平均5．8min，无1例手术中转开胸或发生术中术后并发症。全组随访8～38个月，平均25个月，切口未见明显瘢痕，隐匿于腋毛内完全不可见，所有患者均十分满意手术疗效和美容效果。结论采用经隐痕腋窝单切口胸腔镜下胸交感神经切断施行ETS安全、简捷和有效、切口极为隐蔽，符合美容最佳需求，是一种值得推广应用的手术切口。Objective To evaluate the cosmetic effect and safety of transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis （PH）. Methods Retrospective studywas conducted for 326 PH cases undergoing transaxillary concealing single incision endoscopic thoracic bilateral sympathectomy during January 2009 and March 2011. Results All operations were successfully performed without severe complication and mortality. No conversion into open technique was necessary. The mean unilateral operative duration was 5.8 （5 - 8 ） min. It was calculated from the time of skin incision to the application of dressing over wound. The mean follow-up period was 25 （ 8 - 38 ） months. All patients achieved excellent cosmetic effects with undetectable incision. Conclusion Transaxillary concealing single incision endoscopic thoracic sympathectomy is a safe and effective procedure for treating primary PH. Incision is undeteetable with excellent cosmetic effect. It is worthy of wider popularization.

关 键 词：胸腔镜 交感神经系统 手汗症 

分 类 号：R655[医药卫生—外科学]