[1]王俊彬 刘继先** 李灼① 苏文杰① 叶艺旺.3 mm胸腔镜联合免trocar电凝钩经乳晕切口治疗男性手汗症[J].中国微创外科杂志,2018,18(12):1121-1124.
 Wang Junbin*,Liu Jixian*,Li Zhuo,et al.The 3mm Thoracoscope Combined With Trocarfree Electrocoagulation Hook for Treatment of Male Palmar Hyperhidrosis Through Periareolar Incision[J].Chinese Journal of Minimally Invasive Surgery,2018,18(12):1121-1124.
点击复制

3 mm胸腔镜联合免trocar电凝钩经乳晕切口治疗男性手汗症()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年12期
页码:
1121-1124
栏目:
技术改进
出版日期:
2018-12-20

文章信息/Info

Title:
The 3mm Thoracoscope Combined With Trocarfree Electrocoagulation Hook for Treatment of Male Palmar Hyperhidrosis Through Periareolar Incision
作者:
王俊彬 刘继先** 李灼① 苏文杰① 叶艺旺
(北京大学深圳医院胸外科,深圳518000)
Author(s):
Wang Junbin* Liu Jixian* Li Zhuo et al.
*Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen 518000, China
关键词:
3 mm胸腔镜乳晕切口胸交感神经链切断术手汗症
Keywords:
3mm thoracoscopePeriareolar incisionThoracic sympathectomyPalmar hyperhidrosis
文献标志码:
B
摘要:
目的探讨3 mm针式胸腔镜联合2 mm免trocar电凝钩经乳晕切口行胸交感神经链切断术治疗男性原发性手汗症(primary hyperhidrosis,PH)的可行性。方法2016 年6月~2018年2月对18例男性PH,3 mm胸腔镜经乳晕外侧缘做一3 mm切口,2 mm免trocar电凝钩经乳晕内侧缘行T3、T4胸交感神经链切断术。结果18例均顺利完成手术,手术时间20~58 min,平均29.4 min。出血量2~5 ml,平均2.3 ml。术后住院1~3 d,平均1.3 d。术后手汗症状均消失,12例轻度代偿性出汗,3例气胸,2例少量胸腔积液,13例切口感觉异常,5例切口轻度疼痛。18例术后随访1~19个月,平均11.5月,均达到有效标准,未出现中重度代偿性出汗,手术切口甲级愈合,愈合后较隐蔽。结论3 mm针式胸腔镜联合2 mm免trocar电凝钩经乳晕切口行胸交感神经链切断术治疗男性PH效果良好,安全,手术切口隐蔽,符合微创及美学要求,具有可行性。
Abstract:
ObjectiveTo explore the feasibility of 3mm needlelike thoracoscope combined with 2mm trocarfree electrocoagulation hook through the periareolar incision to perform the thoracic sympathectomy for the treatment of male palmar hyperhidrosis. MethodsFrom June 2016 to February 2018, 18 cases of male primary palmar hyperhidrosis were treated by 3mm thoracoscope with a 3mm incision through the lateral edge of areola and 2mm trocarfree electrocoagulation hook through the medial edge of areola for T3 and T4 thoracic sympathectomy.ResultsAll the 18 patients were given operation successfully. The operative time was 20-58 min with an average of 29.4 min. The amount of bleeding was 2-5 ml with an average of 2.3 ml. The postoperative hospital stay was 1-3 d with an average of 1.3 d. After operation, the palmar hyperhidrosis disappeared. There were 12 cases of mild compensatory sweating, 3 cases of pneumothorax, 2 cases of small pleural effusion, 13 cases of abnormal incision sensation and 5 cases of slight incision pain. All the cases were followed up for 1-19 months with an average of 11.5 months. There was no moderate or severe compensatory sweating. The healing of the surgical incision was graded A. The incision was concealed after healing.ConclusionsThe 3mm needlelike thoracoscope combined with 2mm trocarfree electrocoagulation hook through the periareolar incision to perform the thoracic sympathectomy for the treatment of male palmar hyperhidrosis is effective, safe, and feasible. The surgical incision is concealed, in line with minimally invasive and aesthetic requirements.

参考文献/References:

[1]Lai YT,Yang LH,Chio CC,et al. Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy.Neurosurgery,1997,41(1):110-114.
[2]Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol,2004,51(2):274-286.
[3]涂远荣,主编.手汗症现代微创治疗.福州:福建科技出版社,2007.82-84.
[4]Strutton DR, Kowalski JW, Glaser DA, et al. US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. J Am Acad Dermatol,2004,51(2):241-248.
[5]Drott C. Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm.Clin Auton Res,2003,13(Suppl 1):S126-S130.
[6]沈国义,张奕,黄镇,等.胸腔镜单孔隐蔽切口治疗手汗症30例.中国微创外科杂志,2014,14(1):66-68.
[7]涂远荣,赖繁彩,李旭,等.胸腔镜经乳晕单切口胸交感神经切断术治疗手汗症.中华医学杂志,2011,91(44):3131-3133.
[8]张小川,仲宁,李星,等.经乳晕单孔胸腔镜交感神经切断术治疗手汗症.中国微创外科杂志,2017,17(10):939-941.
[9]蔡小碧,陈捷,程可洛,等.3 mm针式胸腔镜下胸交感神经干切断术治疗原发性手汗症27例.广东医学院学报,2014,32(1):33-34.
[10]赖光湖,杜铭,陈焕文,等.人工气胸在胸腔镜下胸交感神经链切断术中的价值.中国微创外科杂志,2013,13(5):401-402.
[11]林敏,涂远荣,李旭赖.不同节段胸交感神经干切断术治疗手汗症的疗效比较.中华医学杂志,2006,869(33):2315- 2317.

备注/Memo

备注/Memo:
基金项目:深圳市科技计划项目(JCYJ20150403091443290);广东省自然科学基金-博士启动项目(2017A030310641);JI资助项目**通讯作者,Email:252110465@qq.com①(深圳市宝安区人民医院胸心外科,深圳518000)
更新日期/Last Update: 2019-03-01