Clinical Evaluation of 31 T3+T4 Thoracoscopic Sympathectomy Cases for Palmar Hyperhidrosis

LIAO Yufei; YE lin

doi:10.13730/j.issn.1009-2595.2018.08.004

Abstract：Objective To discuss the palm temperature changes and postoperative effect of the 3 rd thoracic (T3) +the 4 th thoracic (T4) thoracoscopic sympathectomy and bypass fiber resection for the treatment of palmar hyperhidrosis.Methods From April 2012 to January 2018, a total of 31 palmar hyperhidrosis patients who went through T3+ T4 thoracoscopic sympathectomy plus bypass fiber (Kuntz fiber) resection were divided into two groups.Group L was operated on left thorax and cut in the order T3, T4, Kuntz fiber.Group R was operated on right thorax and cut in the order T4, T3, Kuntz fiber.Palm temperatures on both sides were detected at pre-operation, five minutes after cutting T3 or T4 and Kuntz fiber resection, and the changes were observed.Results Palmaris temperatures of two groups were all increased 1-3 (2.1±0.7) ℃ (P＜0.05).The temperature of group L increased (2.2±0.7) ℃ (P＜0.05), the temperature of group R increased (2.1±0.8) ℃ (P＜0.05), and palm hyperhidrosis symptoms disappeared.The palm temperature was obviously higher at five minutes after left T3 resection[ (1.9±0.3) ℃, (P＜0.05) ], and compared with cutting T3, the palm temperature continued to rise after cutting T4 and Kuntz fiber resection[ (0.5±0.2) ℃, P＜0.05].The palm temperature remarkablely increased at five minutes after cutting right T4[ (1.8±0.3) ℃, (P＜0.05) ], and the palm temperature continued to rise at five minutes after cutting T3 and Kuntz fiber resection[ (0.4±0.3) ℃, P＜0.05].No significantly differences were found in both sides of palm temperatures (P＞0.05).Conclusion T3 and T4 separately or jointly resection both can increase the palm temperatures remarkably and reliably.Thoracoscopic T3+ T4 sympathectomy and bypass fiber resection is a minimally invasive, safe and efficient treatment for palmar hyperhidrosis.