Clinical Research Of Single Port Thoracoscopic T3,T4 Sympathectomy For Palmar Hyperhidrosis

Objective:Palmar hyperhidrosis is a common functional hyperhidrosis with unknown causes.Although it does not endanger the life of patients,it has different degrees of impact on their life,work and mental health.Because people don’t know enough about palmar hyperhidrosis,they think it is a disease of internal medicine.Palmar hyperhidrosis is mainly treated by traditional Chinese medicine,external application of antiperspirant,iontophoresis,sympathetic nerve block and other conservative methods,but the cost of treatment is relatively high,the treatment effect is unstable,there are many adverse reactions,and it is easy to relapse.Then,through the popular science books of health knowledge and convenient network,people realized that palmar hyperhidrosis is actually a curable disease in thoracic surgery.Thoracic sympathectomy for palmar hyperhidrosis patients has also achieved a certain effect,and with the development of minimally invasive surgery,thoracoscopic surgery has been used,and the operation has become more minimally invasive.By reviewing the cases of palmar hyperhidrosis in our hospital,we analyzed and summarized the advantages of single port thoracoscopic T3 and T4 sympathectomy in the treatment of palmar hyperhidrosis compared with double port thoracoscopic treatment and the related surgical experience.Methods:By reviewing the cases of primary palmar hyperhidrosis in thoracic surgery department of our hospital from October 2018 to January 2021,all patients were treated by in-hospital surgery.The surgical methods were divided into "single hole thoracoscopic T3,T4 sympathectomy" and "double hole thoracoscopic T3,T4 sympathectomy ".The differences of gender,age,blood loss,postoperative hospital stay,postoperative efficacy,postoperative complications and mortality were statistically analyzed.Results:In this study,a total of 22 patients were included,including 13 male patients,9 single hole group,4 double hole group,9 female patients,7 single hole group,2 double hole group,P=1;the average age of single hole group was 21.94±5.18 years old,and that of double hole group was 21.83±2.93 years old,P=0.737;There were 8 cases of severe palmar hyperhidrosis,4 cases in single hole group,4 cases in double hole group,14 cases in moderate palmar hyperhidrosis,12 cases in single hole group and 2 cases in double hole group,P=0.137.There was no significant difference in general conditions between the two groups.Incision length:1.94 ± 0.75 cm in single hole group,4.67 ± 0.52 cm in double hole group,P=0,operation time:41.56 ± 3.01 min in single hole group,54.17 ± 3.76 min in double hole group,P=0,compared with two groups,P<0.05,the difference was statistically significant.24 hours after operation,the pain score of single hole group was 2.88 ± 0.89,which was significantly lower than that of double hole group(4.17± 0.75),P<0.05,the difference was statistically significant.There was no significant difference between the two groups in operation effect,blood loss,postoperative hospital stay and postoperative complications.Conclusion:Thoracoscopic T3 and T4 sympathectomy is safe and effective in the treatment of palmar hyperhidrosis.There was no significant difference in intraoperative blood loss,postoperative hospital stay,surgical effect and postoperative complications between the two groups.However,the operation time and incision length of the single hole group were significantly shorter than those of the double hole group,the postoperative pain was lighter,the incision was smaller,and the incision was more hidden,which met the aesthetic pursuit of people and was conducive to the postoperative recovery of patients.