Safety and feasibility of thoracic sympathectomy in the treatment of primary palmar hyperhidrosis based on ambulatory surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAI Linsheng ¹ , YU Yang ² , NING Xiangu ² , XU Jiayang ¹ , YE Jia ¹ , LIU Rongsheng ¹ , CHEN Xinlong ² ,  PENG Jun ²

1. School of Medicine, Kunming University of Science and Technology, Kunming, 650100, P. R. China;
2. Department of Thoracic Surgery, The First People’s Hospital of Yunnan Province Affiliated to Kunming University of Science and Technology, Kunming, 650100, P. R. China;

Corresponding author：

PENG Jun, Email: 389647518@qq.com

Keywords：

Primary palmar hyperhidrosis; video-assisted thoracoscopic sympathectomy; enhanced recovery after surgery; ambulatory surgery

DOI：

10.7507/1007-4848.202102077

Video：

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Objective To investigate the clinical safety and feasibility of thoracic sympathectomy in the treatment of palmar hyperhidrosis based on ambulatory surgery.Methods A retrospective analysis of 74 patients who underwent thoracoscopic sympathectomy in the Department of Thoracic Surgery of the First People's Hospital of Yunnan Province from January 2017 to April 2021 was performed, including 35 males and 39 females aged 12-38 (21.32±4.13) years. Patients were divided into two groups according to different treatments. There were 34 patients in a control group (adopting traditional surgery), and 40 patients in an observation group (adopting ambulatory surgery). The clinical effects of the two groups were compared.Results No massive bleeding, conversion to thoracotomy, postoperative pneumothorax or severe pneumonia occured in all patients. Univariate analysis of intraoperative indexes showed that the two groups had no statistical difference in total hospitalization cost, operation time, anesthesia time or postoperative waiting time (P>0.05). The amount of intraoperative blood loss in the observation group was less than that in the control group (P<0.05). The time of postoperative out of bed and recovery of walking capacity and the incidence of electrolyte disturbance in the observation group were shorter or lower than those in the control group (P<0.05). There was no statistical difference in white blood count, neutrophils count or postoperative 24 h pulse oxygen saturation fluctuation peak between the two groups (P>0.05).Conclusion Based on the optimized diagnosis and treatment model, thoracoscopic sympathectomy with laryngeal mask airway which is performed during ambulatory surgery, is feasible and worth popularizing in thoracic surgery.

Citation： CAI Linsheng, YU Yang, NING Xiangu, XU Jiayang, YE Jia, LIU Rongsheng, CHEN Xinlong, PENG Jun. Safety and feasibility of thoracic sympathectomy in the treatment of primary palmar hyperhidrosis based on ambulatory surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(2): 280-285. doi: 10.7507/1007-4848.202102077 Copy

1.	Fujimoto T, Kawahara K, Yokozeki H. Epidemiological study and considerations of primary focal hyperhidrosis in Japan: From questionnaire analysis. J Dermatol, 2013, 40(11): 886-890.
2.	Hughes J. Endothoracic sympathectomy. Proc R Soc Med, 1942, 35(9): 585-586.
3.	Shen C, Che G. Tubeless minimally invasive treatment: Taking a new step in enhanced recovery after surgery (ERAS). Thorac Cancer, 2019, 10(11): 2067-2070.
4.	Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
5.	Gonzalez-Rivas D, Yang Y, Guido W, et al. Non-intubated (tubeless) uniportal video-assisted thoracoscopic lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 151-153.
6.	张晓辉. 日间手术发展研究. 中国医院, 2015, 19(4): 1-3.
7.	嵇武, 刘亚萍. 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.
8.	Gorelick J, Friedman A. Diagnosis and management of primary hyperhidrosis: Practical guidance and current therapy update. J Drugs Dermatol, 2020, 19(7): 704-710.
9.	Moon MH, Hyun K, Park JK, et al. Surgical treatment of compensatory hyperhidrosis: Retrospective observational study. Medicine (Baltimore), 2020, 99(42): e22466.
10.	Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
11.	Valeberg BT, Dihle A, Småstuen MC, et al. The effects of a psycho-educational intervention to improve pain management after day surgery: A randomised clinical trial. J Clin Nurs, 2021, 30(7-8): 1132-1143.
12.	Joshi GP. Enhanced recovery pathways for ambulatory surgery. Curr Opin Anaesthesiol, 2020, 33(6): 711-717.
13.	Ho YL, Fauzi M, Sothee K, et al. Diagnosis, impact and management of hyperhidrosis including endoscopic thoracic sympathectomy. Med J Malaysia, 2020, 75(5): 555-560.
14.	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.
15.	曹庆, 王颖, 朱毅, 等. 关于加速康复外科理念在日间手术应用的探讨. 中国康复医学杂志, 2020, 35(7): 876-880.
16.	谢亮, 陈刚, 王庆, 等. 非气管内插管麻醉监护下局部麻醉胸腔镜交感神经切断术治疗多汗症的随机对照试验. 中国胸心血管外科临床杂志, 2014, 21(1): 11-16.
17.	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.
18.	Medbery RL, Fernandez FG, Khullar OV. ERAS and patient reported outcomes in thoracic surgery: A review of current data. J Thorac Dis, 2019, 11(Suppl 7): S976-S986.
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.	李冬, 沈琦斌, 陈超, 等. 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.
21.	Gálvez C, Bolufer S, Gálvez E, et al. Anatomic segmentectomy in nonintubated video-assisted thoracoscopic surgery. Thorac Surg Clin, 2020, 30(1): 61-72.

1. Fujimoto T, Kawahara K, Yokozeki H. Epidemiological study and considerations of primary focal hyperhidrosis in Japan: From questionnaire analysis. J Dermatol, 2013, 40(11): 886-890.
2. Hughes J. Endothoracic sympathectomy. Proc R Soc Med, 1942, 35(9): 585-586.
3. Shen C, Che G. Tubeless minimally invasive treatment: Taking a new step in enhanced recovery after surgery (ERAS). Thorac Cancer, 2019, 10(11): 2067-2070.
4. Batchelor TJP, Ljungqvist O. A surgical perspective of ERAS guidelines in thoracic surgery. Curr Opin Anaesthesiol, 2019, 32(1): 17-22.
5. Gonzalez-Rivas D, Yang Y, Guido W, et al. Non-intubated (tubeless) uniportal video-assisted thoracoscopic lobectomy. Ann Cardiothorac Surg, 2016, 5(2): 151-153.
6. 张晓辉. 日间手术发展研究. 中国医院, 2015, 19(4): 1-3.
7. 嵇武, 刘亚萍. 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.
8. Gorelick J, Friedman A. Diagnosis and management of primary hyperhidrosis: Practical guidance and current therapy update. J Drugs Dermatol, 2020, 19(7): 704-710.
9. Moon MH, Hyun K, Park JK, et al. Surgical treatment of compensatory hyperhidrosis: Retrospective observational study. Medicine (Baltimore), 2020, 99(42): e22466.
10. Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
11. Valeberg BT, Dihle A, Småstuen MC, et al. The effects of a psycho-educational intervention to improve pain management after day surgery: A randomised clinical trial. J Clin Nurs, 2021, 30(7-8): 1132-1143.
12. Joshi GP. Enhanced recovery pathways for ambulatory surgery. Curr Opin Anaesthesiol, 2020, 33(6): 711-717.
13. Ho YL, Fauzi M, Sothee K, et al. Diagnosis, impact and management of hyperhidrosis including endoscopic thoracic sympathectomy. Med J Malaysia, 2020, 75(5): 555-560.
14. 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.
15. 曹庆, 王颖, 朱毅, 等. 关于加速康复外科理念在日间手术应用的探讨. 中国康复医学杂志, 2020, 35(7): 876-880.
16. 谢亮, 陈刚, 王庆, 等. 非气管内插管麻醉监护下局部麻醉胸腔镜交感神经切断术治疗多汗症的随机对照试验. 中国胸心血管外科临床杂志, 2014, 21(1): 11-16.
17. 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.
18. Medbery RL, Fernandez FG, Khullar OV. ERAS and patient reported outcomes in thoracic surgery: A review of current data. J Thorac Dis, 2019, 11(Suppl 7): S976-S986.
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. 李冬, 沈琦斌, 陈超, 等. 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.
21. Gálvez C, Bolufer S, Gálvez E, et al. Anatomic segmentectomy in nonintubated video-assisted thoracoscopic surgery. Thorac Surg Clin, 2020, 30(1): 61-72.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Safety and feasibility of thoracic sympathectomy in the treatment of primary palmar hyperhidrosis based on ambulatory surgery

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