The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery: A retrospective cohort study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Haiqi ¹ , ZHAO Heng ¹ , MA Lei ² , WANG Zhe ¹ , WEN Xiaopeng ¹ , ZHANG Jia ¹ , JIA Zhuoqi ¹ , WU Qifei ¹ , ZHANG Yong ¹ ,  ZHANG Guangjian ¹ , FU Junke ¹

1. Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China;
2. Department of Operation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, P. R. China;

Corresponding author：

ZHANG Guangjian, Email: michael8039@xjtu.edu.cn

Keywords：

Palmar hyperhidrosis; endoscopic thoracic sympathicotomy; day surgery; enhanced recovery after surgery

DOI：

10.7507/1007-4848.202202028

Video：

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Objective To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P＜0.001). The satisfaction rate in both groups was greater than 95%. Conclusion Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.

Citation： HE Haiqi, ZHAO Heng, MA Lei, WANG Zhe, WEN Xiaopeng, ZHANG Jia, JIA Zhuoqi, WU Qifei, ZHANG Yong, ZHANG Guangjian, FU Junke. The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery: A retrospective cohort study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(11): 1556-1560. doi: 10.7507/1007-4848.202202028 Copy

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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.	Romero FR, Haddad GR, Miot HA, et al. Palmar hyperhidrosis: Clinical, pathophysiological, diagnostic and therapeutic aspects. An Bras Dermatol, 2016, 91(6): 716-725.
4.	Hamm H, Naumann MK, Kowalski JW, et al. Primary focal hyperhidrosis: Disease characteristics and functional impairment. Dermatology, 2006, 212(4): 343-353.
5.	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.
6.	涂远荣, 刘彦国, 中国手汗症微创治疗临床指南编写委员会. 中国手汗症微创治疗临床指南(2021年版). 中国胸心血管外科临床杂志, 2021, 28(10): 1133-1139.
7.	Hughes J. Endothoracic sympathectomy. Proc R Soc Med, 1942, 35(9): 585-586.
8.	Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
9.	车国卫. 加速康复外科—临床应用加减之间? 中国肺癌杂志, 2019, 22(11): 681-686.
10.	Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
11.	Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
12.	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.
13.	Solish N, Bertucci V, Dansereau A, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: Recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg, 2007, 33(8): 908-923.
14.	嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
15.	沈诚, 常帅, 周坤, 等. 加速康复外科和日间手术模式在胸外科中的应用现状及发展前景. 中国肺癌杂志, 2020, 23(9): 800-805.
16.	代小探, 宋平平, 张百江. 非气管插管在胸外科VATS中的应用. 中国肺癌杂志, 2016, 19(5): 312-316.
17.	陈立如, 徐全, 林庆, 等. 非气管插管麻醉对加速康复外科理念在原发性手汗症患者手术治疗中的体现. 中华胸部外科电子杂志, 2017, 4(3): 181-185.
18.	李冬, 沈琦斌, 陈超. 日间喉罩全麻联合单孔胸腔镜交感神经切断术治疗手汗症效果观察. 浙江医学, 2019, 41(10): 1059-1061.
19.	曹守强, 董庆, 韩敬泉, 等. 日间手术治疗手汗症的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(6): 537-541.
20.	陈安平, 龚明, 黎兰, 等. 日间快速康复模式下胸腔镜交感神经切断术治疗手汗症的单中心回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(3): 301-305.
21.	Kuijpers M, van Zanden JE, Harms PW, et al. Minimally invasive sympathicotomy for palmar hyperhidrosis and facial blushing: Current status and the hyperhidrosis expert center approach. J Clin Med, 2022, 11(3): 786.

1. Lai FC, Tu YR, Li YP, et al. Nation wide epidemiological survey of primary palmar hyperhidrosis in the People's Republic of China. Clin Auton Res, 2015, 25(2): 105-108.
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. Romero FR, Haddad GR, Miot HA, et al. Palmar hyperhidrosis: Clinical, pathophysiological, diagnostic and therapeutic aspects. An Bras Dermatol, 2016, 91(6): 716-725.
4. Hamm H, Naumann MK, Kowalski JW, et al. Primary focal hyperhidrosis: Disease characteristics and functional impairment. Dermatology, 2006, 212(4): 343-353.
5. 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.
6. 涂远荣, 刘彦国, 中国手汗症微创治疗临床指南编写委员会. 中国手汗症微创治疗临床指南(2021年版). 中国胸心血管外科临床杂志, 2021, 28(10): 1133-1139.
7. Hughes J. Endothoracic sympathectomy. Proc R Soc Med, 1942, 35(9): 585-586.
8. Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
9. 车国卫. 加速康复外科—临床应用加减之间? 中国肺癌杂志, 2019, 22(11): 681-686.
10. Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
11. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg, 2017, 152(3): 292-298.
12. 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.
13. Solish N, Bertucci V, Dansereau A, et al. A comprehensive approach to the recognition, diagnosis, and severity-based treatment of focal hyperhidrosis: Recommendations of the Canadian Hyperhidrosis Advisory Committee. Dermatol Surg, 2007, 33(8): 908-923.
14. 嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
15. 沈诚, 常帅, 周坤, 等. 加速康复外科和日间手术模式在胸外科中的应用现状及发展前景. 中国肺癌杂志, 2020, 23(9): 800-805.
16. 代小探, 宋平平, 张百江. 非气管插管在胸外科VATS中的应用. 中国肺癌杂志, 2016, 19(5): 312-316.
17. 陈立如, 徐全, 林庆, 等. 非气管插管麻醉对加速康复外科理念在原发性手汗症患者手术治疗中的体现. 中华胸部外科电子杂志, 2017, 4(3): 181-185.
18. 李冬, 沈琦斌, 陈超. 日间喉罩全麻联合单孔胸腔镜交感神经切断术治疗手汗症效果观察. 浙江医学, 2019, 41(10): 1059-1061.
19. 曹守强, 董庆, 韩敬泉, 等. 日间手术治疗手汗症的病例对照研究. 中国胸心血管外科临床杂志, 2016, 23(6): 537-541.
20. 陈安平, 龚明, 黎兰, 等. 日间快速康复模式下胸腔镜交感神经切断术治疗手汗症的单中心回顾性队列研究. 中国胸心血管外科临床杂志, 2022, 29(3): 301-305.
21. Kuijpers M, van Zanden JE, Harms PW, et al. Minimally invasive sympathicotomy for palmar hyperhidrosis and facial blushing: Current status and the hyperhidrosis expert center approach. J Clin Med, 2022, 11(3): 786.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery: A retrospective cohort study

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