Clinical analysis of adhesion dissection in transaxillary uniporal video-assisted thoracoscopic surgery for palmar hyperhidrosis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Lin ,  LIN Zongwu , XI Junjie , XU Songtao , WANG Qun

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R.China;

Corresponding author：

LIN Zongwu, Email: lin.zongwu@zs-hospital.sh.cn

Keywords：

Uniportal; palmar hyperhidrosis; sympathectomy; adhesion

DOI：

10.7507/1007-4848.201904025

Video：

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Objective To analyze the safety and feasibility of the adhesion dissection in transaxillary uniportal thoracoscopy for palmar hyperhidrosis.Methods Data of 168 patients, including 77 males and 91 females with an average age of 14 - 41 (24.3±5.4) years, who received transaxillary uniportal video-assisted thoracoscopic surgery (VATS) for palmar hyperhidrosis from January 2015 to July 2018 were retrospectively analyzed. Severe adhesion was found in 4 patients and mild adhesion was found in 12 patients. Artificial pneumothorax was used to help dissect adhesion. Preoperative CT scan could help locate the rib according to the relative position to azygos vein or aotic arch.Results All of 168 patients were successfully completed with transaxillary uniportal VATS. Then chest tubes were put in the 4 severe adhesion patients. The tube was removed from one patient after 11 days because of air leak, and from the other three patients on the next day. The other 164 patients with or without adhesion were discharged from hospital on the operation day or the next day.Conclusion Adhesion dissection in transaxillary uniportal VATS for palmar hyperhidrosis is safe and feasibile.

Citation： WANG Lin, LIN Zongwu, XI Junjie, XU Songtao, WANG Qun. Clinical analysis of adhesion dissection in transaxillary uniporal video-assisted thoracoscopic surgery for palmar hyperhidrosis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(3): 323-326. doi: 10.7507/1007-4848.201904025 Copy

1.	Tu YR, Li X, Lin M, et al. Epidemiological survey of primary palmar hyperhidrosis in adolescent in Fuzhou of People's Republic of China. Eur J Cardiothorac Surg, 2007, 31(4): 737-739.
2.	Doolittle J, Walker P, Mills T, et al. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res, 2016, 308(10): 743-749.
3.	Horslen LC, Wilshire CL, Louie BE, et al. Long-term impact of endoscopic thoracic sympathectomy for primary palmar hyperhidrosis. Ann Thorac Surg, 2018, 106(4): 1008-1012.
4.	Georghiou GP, Berman M, Bobovnikov V, et al. Minimally invasive thoracoscopic sympathectomy for palmar hyperhidrosis via a transaxillary single-port approach. Interact Cardiovasc Thorac Surg, 2004, 3(3): 437-441.
5.	林敏, 涂远荣, 赖繁彩, 等. 经腋窝隐痕单切口胸腔镜下胸交感神经切断术治疗手汗症. 中华医学杂志, 2013, 93(41): 3300-3301.
6.	Chao C, Lin HE, Lo WT, et al. Bilateral simultaneous transaxillary sympathectomy in treatment of palmar hyperhidrosis: report of 60 cases. J Formos Med Assoc, 1990, 89(5): 403-405.
7.	Chao C, Tsai CT, Hsiao HC, et al. Transaxillary endoscopic sympathectomy--a report of experience in 150 patients with palmar hyperhidrosis. Surg Laparosc Endosc, 1993, 3(5): 365-369.
8.	Lardinois D, Ris HB. Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach. Eur J Cardiothorac Surg, 2002, 21(1): 67-70.
9.	王先学, 潘道波, 邓恢伟, 等. 不同节段胸交感神经切断术对手汗症患者术后影响的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2017, 24(5): 377-383.
10.	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.
11.	涂远荣, 杨劼, 刘彦国. 中国手汗症微创治疗专家共识. 中华胸心血管外科杂志, 2011, 27(8): 449-451.
12.	涂远荣, 林敏, 陈剑锋, 等. 胸交感神经切断术治疗原发性手汗症2206例: 10年结果和分析. 中国微创外科杂志, 2017, 17(2): 99-103.
13.	Salim EF, Ali GA. Impact of thoracoscopic T2 sympathectomy on patients with primary palmar and axillary hyperhidrosis. Ann Thorac Surg, 2018, 106(4): 1032-1037.
14.	Qian K, Feng YG, Zhou JH, et al. Anxiety after sympathectomy in patients with primary palmar hyperhidrosis may prolong the duration of compensatory hyperhidrosis. J Cardiothorac Surg, 2018, 13(1): 54.
15.	Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
16.	Glaser DA, Ballard AM, Hunt NL, et al. Prevalence of multifocal primary hyperhidrosis and symptom severity over time: results of a targeted survey. Dermatol Surg, 2016, 42(12): 1347-1353.

1. Tu YR, Li X, Lin M, et al. Epidemiological survey of primary palmar hyperhidrosis in adolescent in Fuzhou of People's Republic of China. Eur J Cardiothorac Surg, 2007, 31(4): 737-739.
2. Doolittle J, Walker P, Mills T, et al. Hyperhidrosis: an update on prevalence and severity in the United States. Arch Dermatol Res, 2016, 308(10): 743-749.
3. Horslen LC, Wilshire CL, Louie BE, et al. Long-term impact of endoscopic thoracic sympathectomy for primary palmar hyperhidrosis. Ann Thorac Surg, 2018, 106(4): 1008-1012.
4. Georghiou GP, Berman M, Bobovnikov V, et al. Minimally invasive thoracoscopic sympathectomy for palmar hyperhidrosis via a transaxillary single-port approach. Interact Cardiovasc Thorac Surg, 2004, 3(3): 437-441.
5. 林敏, 涂远荣, 赖繁彩, 等. 经腋窝隐痕单切口胸腔镜下胸交感神经切断术治疗手汗症. 中华医学杂志, 2013, 93(41): 3300-3301.
6. Chao C, Lin HE, Lo WT, et al. Bilateral simultaneous transaxillary sympathectomy in treatment of palmar hyperhidrosis: report of 60 cases. J Formos Med Assoc, 1990, 89(5): 403-405.
7. Chao C, Tsai CT, Hsiao HC, et al. Transaxillary endoscopic sympathectomy--a report of experience in 150 patients with palmar hyperhidrosis. Surg Laparosc Endosc, 1993, 3(5): 365-369.
8. Lardinois D, Ris HB. Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach. Eur J Cardiothorac Surg, 2002, 21(1): 67-70.
9. 王先学, 潘道波, 邓恢伟, 等. 不同节段胸交感神经切断术对手汗症患者术后影响的系统评价与 Meta 分析. 中国胸心血管外科临床杂志, 2017, 24(5): 377-383.
10. 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.
11. 涂远荣, 杨劼, 刘彦国. 中国手汗症微创治疗专家共识. 中华胸心血管外科杂志, 2011, 27(8): 449-451.
12. 涂远荣, 林敏, 陈剑锋, 等. 胸交感神经切断术治疗原发性手汗症2206例: 10年结果和分析. 中国微创外科杂志, 2017, 17(2): 99-103.
13. Salim EF, Ali GA. Impact of thoracoscopic T2 sympathectomy on patients with primary palmar and axillary hyperhidrosis. Ann Thorac Surg, 2018, 106(4): 1032-1037.
14. Qian K, Feng YG, Zhou JH, et al. Anxiety after sympathectomy in patients with primary palmar hyperhidrosis may prolong the duration of compensatory hyperhidrosis. J Cardiothorac Surg, 2018, 13(1): 54.
15. Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
16. Glaser DA, Ballard AM, Hunt NL, et al. Prevalence of multifocal primary hyperhidrosis and symptom severity over time: results of a targeted survey. Dermatol Surg, 2016, 42(12): 1347-1353.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical analysis of adhesion dissection in transaxillary uniporal video-assisted thoracoscopic surgery for palmar hyperhidrosis

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