다한증 환자에서의 T2 Sympathicotomy의 효과

Abstract

Background: Hyperhidrosis of the palms, axillae and face has a strong negative impact on social and professional life. The present existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. A definitive cure can be obtained by upper thoracic sympathectomy. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating. Material and Method: From Sep. 1997 to Feb. 1998, 89 cases of the needle(2 mm) thoracoscopic thoracic sympathicotomy were performed. The second thoracic ganglion was resected by cutting with a endoscissors. Result: A bilateral procedure takes less than 25 min and requires just one night in hospital. There have been no mortality or life-threatening complications. One patient(<2%) required intercostal drainage because of pneumothorax. Primary failure occurred in one cases(<2%) and recurrent hyperhidrosis occurred in no cases. The patients with failure was successfully re-sympathicotomy. At the end of postoperative follow-up(median 3 months), 96.6% of the patients were satisfied. Compensatory sweating occurred in 57 cases(64.0%) with fourteen of those cases classified as either embarrassing in 10 cases(11.2%) or disabling in 4 cases(4.5%). Conclusion: Endoscopic transthoracic sympathicotomy is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis. (Korean J Thorac Cardiovasc Surg 1999;32:171-4)