Şiddetli Palmar ve Aksiller Hiperhidrozu Olan Hastalarda Uniportal ve Multiportal Endoskopik Torasik Sempatektomi’nin Klinik Sonuçları

Amaç: Palmar ve aksiller hiperhidroz, ter bezlerini kontrol eden sempatik sinir sisteminin aşırı uyarılmasından kaynaklanır. Bu çalışma, şiddetli palmar ve aksiller hiperhidroz vakalarında uniportal ve multiportal torasik endoskopik torasik sempatektominin (ETS) klinik sonuçlarını karşılaştırmaktadır.Yöntemler: Bu retrospektif çalışmada şiddetli palmar ve aksiller primer hiperhidroz tanısı konulan 41 hasta incelendi. 2015-2020 yılları arasında göğüs cerrahisi kliniğimizde tüm vakalarımıza ETS uygulandı. Uniportal 24 (%58,5) ve 17 Multiportal (%41,5) olmak üzere iki gruba ayrıldılar. Hastanede kalış süreleri, ilk komplikasyonlar ve üç ay sonra olası nüksler açısından karşılaştırıldılar. Tabakalı ve sürekli değişkenleri değerlendirmek için tanımlayıcı istatistikler kullanıldı.Bulgular: İki grup arasında orta derecede ağrı açısından anlamlı bir fark yoktu. Hastanede 3 gün ve üzeri yatış açısından iki grup arasında anlamlı fark vardı. Ameliyattan 3 ay sonra pitozis, Horner sendromu, ameliyat süresinin uzaması ve hiperhidrozun tekrarlama oranı gibi komplikasyon oranları arasında anlamlı fark yoktu. Bazı hafif ila orta dereceli yan etkiler 6 aylık takipte kendiliğinden kayboldu.Sonuç: Sonuçlar, palmar ve aksiller hiperhidroz tedavisinde uniportal ve multiportal endoskopik torakoskopik sempatektominin (EST) çok etkili, güvenli ve minimal invaziv yöntemler olduğunu göstermiştir. Multiportal yaklaşımla karşılaştırıldığında, uniportal ETS daha az postoperatif ağrıya ve daha az cerrahi süreye neden olur.

Anahtar Kelimeler:

uniportal, multiportal, hiperhidrozis, ETS

Clinical Outcomes of Uniportal Versus Multiportal Endoscopic Thoracic Sympathectomy in Patients With Severe Palmar and Axillary Hyperhidrosis

Aim: Palmar and axillary hyperhidrosis is caused by overstimulation of the sympathetic nervous system that control the sweat glands. This study compares the clinical consequences of uniportal and multiportal thoracic endoscopic thoracic sympathectomy (ETS), in cases of severe palmar and axillary hyperhidrosis.Methods: In this retrospective study, forty-one patients who were diagnosed as severe palmar and axillary primary hyperhidrosis were analyzed. These underwent multiportal ETS between 2015 and 2020 at our thoracic surgery clinic. They were divided into two groups, 24 as uniportal (58.5%) and 17 as multiportal (41.5%). They were compared in terms of the length of hospital stay, the initial complications and possible recurrences after three months. Descriptive statistics were used to evaluate stratified and continuous variables.Results: There was no significant difference in moderate pain between the two groups. There was a significant difference between the two groups in terms of 3 days or more hospitalization. There were no significant difference related to the rate of complications such as ptosis, Horner syndrome, increased duration of surgery and recurrence rate of hyperhidrosis 3 months after surgery. Some mild to moderate side effects disappeared spontaneously at 6-month follow-up.Conclusion: The results showed that uniportal and multiportal endoscopic thoracoscopic sympathectomy (EST) are very effective, safe and minimally invasive methods for the treatment of palmar and axillary hyperhidrosis. Compared to the multiportal approach, uniportal EST causes less postoperative pain and less surgical duration.

Keywords:

uniportal, multiportal, hiperhydrosis, ETS,

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