Palmar Skin Temperature Importance During Transthoracic Endoscopic Sympathectomy For Palmar Hyperhidrosis

摘要

Background :?The primary goal of this study is to identity and analysis age, diagnosis, sympathic chain levels, complications and results associated with successful endoscopic surgical treatment for hyperhydrosis and also this study was to investigate of palmar temperature changes during the operation and to prove the successful surgical procedures and beneficial of the bilateral sympathectomy during the peroperative case.? Methods :?Fifty one patients with severe primary palmar hyperhidrosis received bilateral endoscopic thoracic sympathectomy. Different levels of transection from T4 to T2 were performed step by step until the successful extirpation was implied by the recorded unilateral right palmar temperature intraoperative monitoring. The results of the operations were studied. All patients were followed up and evaluated for symptom resolution, postoperative complication, levels of satisfaction, and severity of compensatory sweating. Effective extirpation ganglia occurred with the intraoperative increasing palmar temperature.? Results :?Of a total of 102 lateral procedures, 76 laterals (76%) ended the procedure at the T4 level, 23 laterals (23%) ended the procedure at the T3-T5 level, and 1 lateral (1%) ended the procedure at the T2 level. The postoperative complication was minor, and no Horner's syndrome was detected. The rate of symptom resolution was 100% and no recurrence was found. The satisfaction rate was 92%, and the incidence of mild, moderate, and severe compensatory sweating were 12%, 8%, and 6%, respectively.? Conclusions :?Concerning the sympathectomy for palmar hyperhidrosis, there is a possibility that the level of the transection varies and should be adjusted for each individual patient. Intraoperative monitoring of temperature may be a useful tool in establishing a kind of standardized reference for finding the correct target level.