A Comparison Of Endoscopic Thoracic Sympathectomy With One Trocar Versus Sympathectomy With Two Trocars In The Treatment Of Primary Palmar Hyperhidrosis

Objective To compare the treatment of primary palmar hyperhidrosisbetween endoscopic thoracic sympathectomy with one trocar andsympathectomy with two trocars.Methods From January2011to December2012,174patients withprimary palmar hyperhidrosis patients received endoscopic thoracicsympathectomy.Two trocars group is composed of75patients whoreceived endoscopic thoracic sympathectomy with two trocars fromJanuary2011to November2011.One trocar group is composed of99patients who received endoscopic thoracic sympathectomy with onetrocar from December2011to December2011.The following informationwere obtained during follow-up period：The curative effect, incisionpain, symptom recurrence and compensatory sweating.Results The operations were successful in all patients.Compared withtwo trocars group,the average operation time(the bilateral surgicalincision from the start to finished sewing the skin, without anesthesia andrecovery time) of one trocar group was significantly shorter ((13.4±2.0)min vs (18.3±2.3) min,P<0.01). There were no serious complications inall patients. Postoperative palm sweating symptoms were disappeared and palm turned dry and warm.174patients were followed up for1-24months, on average (11.0±7.6) months. One month after surgery, theincidence of incision residual pain of one trocar group was significantlylower than that of two trocars group(25.5%vs41.6%, P<0.01).34patientshad appeared various degrees of postoperative compensatory sweating,accounting for19.5%(34/174) in the two groups of patients.16patientsof one trocar group had mild compensatory sweating, accounting for16.2%(16/99).3patients of one trocar group had moderate compensatorysweating, accounting for3.0%(3/99).18patients of two trocars grouphad mild compensatory sweating, accounting for24.0%(18/75).2patientsof two trocars group had moderate compensatory sweating, accountingfor2.7%(2/75). The difference between the two groups was notstatistically significant (P>0.05).Two groups of patients are satisfiedwith the cosmetic results of the incision. In one trocar group,patients whofelt very satisfied was accounting for84.8%(84/99) and those feelingsatisfied is accounting for15.2%(15/99).While in two trocars group,patients who felt very satisfied was accounting for69.3%(52/75) andthose feeling satisfied is accounting for30.7%(23/75). The satisfactionbetween the two groups is statistically significant(X2=6.018, P <0.05).Conclusion Endoscopic thoracic sympathectomy with one trocar forprimary palmar hyperhidrosis is more simple，more safe effective，moreminimally invasive，more beautiful and more worthy clinical promoted application.