Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Xianxue ¹ ,  PAN Daobo ¹ , DENG Huiwei ¹ , ZHOU Quan ² , ZHOU Aiguo ¹

1. Department of Anesthesiology, The First People's Hospital of Changde City, Changde, 415003, Hunan, P.R.China;
2. Science & Education Division, The First People's Hospital of Changde City, Changde, 415003, Hunan, P.R.China;

Corresponding author：

PAN Daobo, Email: pdb0736@aliyun.com

Keywords：

Thoracoscopic sympathectomy; palmar hyperhidrosis; postoperative effects; systematic review/meta-analysis

DOI：

10.7507/1007-4848.201604045

Video：

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Objective To evaluate the postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients. Methods We searched the Wanfang Database, CNKI, Weipu, CBM, PubMed, Cochrane Library (from inception to March 2016) to identify studies about thoracoscopic sympathectomy on palmar hyperhidrosis patients. Quality of the included studies was evaluated. The meta-analysis was performed by RevMan5.3 software. Results A total of 15 studies (9 randomized controlled trials, 3 cohort studies, and 3 retrospective studies) involving 2 542 patients were included. The result of meta-analysis suggested that there was statistical difference in postoperative compensatory hyperhidrosis (OR=4.88, 95% CI 1.88 to 12.68,P=0.001) between T2 sympathectomy and T3 sympathectom. Compared with T2-4 sympathectomy patients, the risk of postoperative compensatory hyperhidrosis in T2-4 sympathectomy group was significantly lower (OR=5.13, 95% CI 2.91 to 9.02,P<0.000 01). Compared with T3 sympathectomy group, the risk of postoperative compensatory hyperhidrosis and hand dry in the T4 sympathectomy group was significantly lower (OR=2.91, 95% CI 2.06 to 4.12,P<0.000 01;OR=14.60, 95% CI 3.06 to 69.63,P=0.000 8), respectively. Conclusion The rate of postoperative compensatory hyperhidrosis or hand dry is lower on T4 sympathectomy patients and supposed to be the best segment for the treatment of palmar hyperhidrosis patients.

Citation： WANG Xianxue, PAN Daobo, DENG Huiwei, ZHOU Quan, ZHOU Aiguo. Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(5): 377-383. doi: 10.7507/1007-4848.201604045 Copy

1.	张家衡, 陈奇, 陈宇鹏, 等. 电视胸腔镜下 T_2、3 交感神经干切断术治疗手汗症的疗效观察. 中国胸心血管外科临床杂志, 2008, 15(5): 373.
2.	周冰, 严志焜, 朱理, 等. 胸腔镜下胸交感神经切除术治疗手汗症 110 例. 中国胸心血管外科临床杂志, 2003, 10(2): 134-135.
3.	张文雄, 徐建军, 熊利华. 单孔电视胸腔镜下交感神经切断术治疗手汗症 48 例临床分析. 中国胸心血管外科临床杂志, 2015, 22(3): 220-224.
4.	任福强, 仇滔, 芮军, 等. 胸腔镜双侧腋下单切口胸交感神经链切断术治疗手汗症. 中国胸心血管外科临床杂志, 2015, 22(1): 54-56.
5.	Chang YT, Li HP, Lee JY, et al. Treatment of palmar hyperhidrosis T4 level compared with T3 and T2. Ann Surg, 2007, 246(2): 330-336.
6.	Yazbek G, Wolosker N, Kauffman P, et al. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics, 2009, 64(8): 743-749.
7.	Yazbek G, Wolosker N, de Campos JR, et al. Palmar hyperhidrosis-which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion? J Vasc Surg, 2005, 42(2): 281-285.
8.	林敏, 涂远荣, 李旭, 等. 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, 86(33): 2315-2317.
9.	Cai S, Huang S, An J, et al. Effect of lowering or restricting sympathectomy levels on compensatory sweating. Clin Auton Res, 2014, 24(3): 143-149.
10.	葛明建, 吴庆琛, 李强, 等. 电视胸腔镜胸交感干并旁路纤维切断术治疗手汗症 355 例分析. 重庆医科大学学报, 2010, 35(10): 1577-1579.
11.	池闻, 刘瑜, 林晓铭. 胸腔镜下胸交感神经干切断术治疗原发性手汗症临床分析. 现代实用医学, 2010, 22(11): 1229-1230.
12.	Kim WO, Kil HK, Yoon KB, et al. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg, 2010, 199(2): 166-169.
13.	Ishy A, de Campos JR, Wolosker N, et al. Objective evaluation of patients with palmar hyperhidrosis submitted to two levels of sympathectomy: T3 and T4. Interact Cardiovasc Thorac Surg, 2011, 12(4): 545-548.
14.	Liu Y, Yang J, Liu J, et al. Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy. Eur J Cardiothorac Surg, 2009, 35(3): 398-402.
15.	Yang J, Tan JJ, Ye GL, et al. T3/T4 thoracic sympathictomy and compensatory sweating in treatment of palmar hyperhidrosis. Chin Med J, 2007, 120(18): 1574-1577.
16.	刘彦国, 杨劼, 王俊, 等. T3、T4 交感神经链切断术治疗手汗症的比较. 中华医学杂志, 2006, 86(33): 2318-2320.
17.	伊严, 杨家恒, 崔经乐. 胸腔镜下不同节段交感神经干切断术治疗手汗症的随机自身对照研究. 微创医学, 2014, 9(1): 25-27.
18.	杨劼, 刘彦国, 谭家驹, 等. 不同位置胸交感链切断治疗手汗症与术后代偿性出汗的关系. 中国胸心血管外科临床杂志, 2006, 13(5): 315-317.
19.	李达周, 陈飞, 陈炜生, 等. 经脐超细胃镜 T3、T4 交感神经毁损术治疗原发性手汗症疗效比较. 中华消化内镜杂志, 2015, 32(11): 725-728.
20.	Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
21.	Rodriguez PM, Freixinet JL, Hussein M, et al. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients. Eur J Cardiothorac Surg, 2008, 34(3): 514-519.

1. 张家衡, 陈奇, 陈宇鹏, 等. 电视胸腔镜下 T_2、3 交感神经干切断术治疗手汗症的疗效观察. 中国胸心血管外科临床杂志, 2008, 15(5): 373.
2. 周冰, 严志焜, 朱理, 等. 胸腔镜下胸交感神经切除术治疗手汗症 110 例. 中国胸心血管外科临床杂志, 2003, 10(2): 134-135.
3. 张文雄, 徐建军, 熊利华. 单孔电视胸腔镜下交感神经切断术治疗手汗症 48 例临床分析. 中国胸心血管外科临床杂志, 2015, 22(3): 220-224.
4. 任福强, 仇滔, 芮军, 等. 胸腔镜双侧腋下单切口胸交感神经链切断术治疗手汗症. 中国胸心血管外科临床杂志, 2015, 22(1): 54-56.
5. Chang YT, Li HP, Lee JY, et al. Treatment of palmar hyperhidrosis T4 level compared with T3 and T2. Ann Surg, 2007, 246(2): 330-336.
6. Yazbek G, Wolosker N, Kauffman P, et al. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics, 2009, 64(8): 743-749.
7. Yazbek G, Wolosker N, de Campos JR, et al. Palmar hyperhidrosis-which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion? J Vasc Surg, 2005, 42(2): 281-285.
8. 林敏, 涂远荣, 李旭, 等. 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, 86(33): 2315-2317.
9. Cai S, Huang S, An J, et al. Effect of lowering or restricting sympathectomy levels on compensatory sweating. Clin Auton Res, 2014, 24(3): 143-149.
10. 葛明建, 吴庆琛, 李强, 等. 电视胸腔镜胸交感干并旁路纤维切断术治疗手汗症 355 例分析. 重庆医科大学学报, 2010, 35(10): 1577-1579.
11. 池闻, 刘瑜, 林晓铭. 胸腔镜下胸交感神经干切断术治疗原发性手汗症临床分析. 现代实用医学, 2010, 22(11): 1229-1230.
12. Kim WO, Kil HK, Yoon KB, et al. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg, 2010, 199(2): 166-169.
13. Ishy A, de Campos JR, Wolosker N, et al. Objective evaluation of patients with palmar hyperhidrosis submitted to two levels of sympathectomy: T3 and T4. Interact Cardiovasc Thorac Surg, 2011, 12(4): 545-548.
14. Liu Y, Yang J, Liu J, et al. Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy. Eur J Cardiothorac Surg, 2009, 35(3): 398-402.
15. Yang J, Tan JJ, Ye GL, et al. T3/T4 thoracic sympathictomy and compensatory sweating in treatment of palmar hyperhidrosis. Chin Med J, 2007, 120(18): 1574-1577.
16. 刘彦国, 杨劼, 王俊, 等. T3、T4 交感神经链切断术治疗手汗症的比较. 中华医学杂志, 2006, 86(33): 2318-2320.
17. 伊严, 杨家恒, 崔经乐. 胸腔镜下不同节段交感神经干切断术治疗手汗症的随机自身对照研究. 微创医学, 2014, 9(1): 25-27.
18. 杨劼, 刘彦国, 谭家驹, 等. 不同位置胸交感链切断治疗手汗症与术后代偿性出汗的关系. 中国胸心血管外科临床杂志, 2006, 13(5): 315-317.
19. 李达周, 陈飞, 陈炜生, 等. 经脐超细胃镜 T3、T4 交感神经毁损术治疗原发性手汗症疗效比较. 中华消化内镜杂志, 2015, 32(11): 725-728.
20. Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
21. Rodriguez PM, Freixinet JL, Hussein M, et al. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients. Eur J Cardiothorac Surg, 2008, 34(3): 514-519.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis

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