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수장부 다한증에 제한적 교감신경절간 절단술의 장기 고찰
채진호(Jin Ho Chai),최봉춘(Bong Chun Choi),이영철(Yong Chul Lee) 대한통증학회 2001 The Korean Journal of Pain Vol.14 No.1
N/A Background: Conventional thoracoscopic sympathectomy or sympathicotomy is an effective method in treating localized hyperhidrosis; however, this may result in a postoperatively compensatory hyper- hidrosis or facial anhidrosis in the treatment of palmar hyperhidrosis. We modified the conventional sympathicotomy by limiting the extent of nerve transection (limited T3 sympathicotomy) since May 199S. However, there are many reports of a good short-term outcome of limited T3 sympathicotomy. Therefore, we reviewed long-term follow-up of limited T3 sympathicotomy based on outcomes analysis using a questionnaire. Methods: Fifty four patients with palmar hyperhidrosis underwent a limited T3 sympathicotomy between May 1998 and March 1999 and had a complete follow-up over two years using a questionnaire (the mean follow-up was 2.6 years). The patients' postoperative satisfaction was determined by their subjective responses to the questionnaires; the degree of compensatory hyperhidrosis, the effects on foot hyperhidrosis, gustatory hyperhidrosis and facial dryness, and recurrence, and patients satisfaction. Results: Of the total, 87% of patients had a compensatory hyperhidrosis and 3.7% of them were disabled. 31.5% of patients showed improvement in foot hyperhidrosis, while 68.5% of patients demonstrated no change or got worse. 31.5% of patients had gustatory hyperhidrosis and facial dryness and 22.2% of patients showed a mild palmar hyperhidrosis. The postoperative patients satisfaction was significantly in 96.3% of patients. Conclusions: The limited T3 sympathicotomy is a highly effective treatment of palmar hyperhidrosis and has a low rate of postoperative compensatory hyperhidrosis, gustatory hyperhidrosis, and facial dryness.
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