Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Xianxue ¹ ,  PAN Daobo ¹ , DENG Huiwei ¹ , ZHOU Quan ² , ZHOU Aiguo ¹

1. Department of Anesthesiology, The First People's Hospital of Changde City, Changde, 415003, Hunan, P.R.China;
2. Science & Education Division, The First People's Hospital of Changde City, Changde, 415003, Hunan, P.R.China;

Corresponding?author：

PAN Daobo, Email: pdb0736@aliyun.com

Keywords：

Thoracoscopic sympathectomy; palmar hyperhidrosis; postoperative effects; systematic review/meta-analysis

DOI：

10.7507/1007-4848.201604045

Video：

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Objective To evaluate the postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients. Methods We searched the Wanfang Database, CNKI, Weipu, CBM, PubMed, Cochrane Library (from inception to March 2016) to identify studies about thoracoscopic sympathectomy on palmar hyperhidrosis patients. Quality of the included studies was evaluated. The meta-analysis was performed by RevMan5.3 software. Results A total of 15 studies (9 randomized controlled trials, 3 cohort studies, and 3 retrospective studies) involving 2 542 patients were included. The result of meta-analysis suggested that there was statistical difference in postoperative compensatory hyperhidrosis (OR=4.88, 95% CI 1.88 to 12.68,P=0.001) between T2 sympathectomy and T3 sympathectom. Compared with T2-4 sympathectomy patients, the risk of postoperative compensatory hyperhidrosis in T2-4 sympathectomy group was significantly lower (OR=5.13, 95% CI 2.91 to 9.02,P<0.000 01). Compared with T3 sympathectomy group, the risk of postoperative compensatory hyperhidrosis and hand dry in the T4 sympathectomy group was significantly lower (OR=2.91, 95% CI 2.06 to 4.12,P<0.000 01;OR=14.60, 95% CI 3.06 to 69.63,P=0.000 8), respectively. Conclusion The rate of postoperative compensatory hyperhidrosis or hand dry is lower on T4 sympathectomy patients and supposed to be the best segment for the treatment of palmar hyperhidrosis patients.

Citation： WANG Xianxue, PAN Daobo, DENG Huiwei, ZHOU Quan, ZHOU Aiguo. Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(5): 377-383. doi: 10.7507/1007-4848.201604045 Copy

1.	?張家衡, 陳奇, 陳宇鵬, 等. 電視胸腔鏡下 T_2、3 交感神經干切斷術治療手汗癥的療效觀察. 中國胸心血管外科臨床雜志, 2008, 15(5): 373.
2.	周冰, 嚴志焜, 朱理, 等. 胸腔鏡下胸交感神經切除術治療手汗癥 110 例. 中國胸心血管外科臨床雜志, 2003, 10(2): 134-135.
3.	張文雄, 徐建軍, 熊利華. 單孔電視胸腔鏡下交感神經切斷術治療手汗癥 48 例臨床分析. 中國胸心血管外科臨床雜志, 2015, 22(3): 220-224.
4.	任福強, 仇滔, 芮軍, 等. 胸腔鏡雙側腋下單切口胸交感神經鏈切斷術治療手汗癥. 中國胸心血管外科臨床雜志, 2015, 22(1): 54-56.
5.	Chang YT, Li HP, Lee JY, et al. Treatment of palmar hyperhidrosis T4 level compared with T3 and T2. Ann Surg, 2007, 246(2): 330-336.
6.	Yazbek G, Wolosker N, Kauffman P, et al. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics, 2009, 64(8): 743-749.
7.	Yazbek G, Wolosker N, de Campos JR, et al. Palmar hyperhidrosis-which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion? J Vasc Surg, 2005, 42(2): 281-285.
8.	林敏, 涂遠榮, 李旭, 等. 不同節段胸交感神經干切斷術治療手汗癥的療效比較. 中華醫學雜志, 2006, 86(33): 2315-2317.
9.	Cai S, Huang S, An J, et al. Effect of lowering or restricting sympathectomy levels on compensatory sweating. Clin Auton Res, 2014, 24(3): 143-149.
10.	葛明建, 吳慶琛, 李強, 等. 電視胸腔鏡胸交感干并旁路纖維切斷術治療手汗癥 355 例分析. 重慶醫科大學學報, 2010, 35(10): 1577-1579.
11.	池聞, 劉瑜, 林曉銘. 胸腔鏡下胸交感神經干切斷術治療原發性手汗癥臨床分析. 現代實用醫學, 2010, 22(11): 1229-1230.
12.	Kim WO, Kil HK, Yoon KB, et al. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg, 2010, 199(2): 166-169.
13.	Ishy A, de Campos JR, Wolosker N, et al. Objective evaluation of patients with palmar hyperhidrosis submitted to two levels of sympathectomy: T3 and T4. Interact Cardiovasc Thorac Surg, 2011, 12(4): 545-548.
14.	Liu Y, Yang J, Liu J, et al. Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy. Eur J Cardiothorac Surg, 2009, 35(3): 398-402.
15.	Yang J, Tan JJ, Ye GL, et al. T3/T4 thoracic sympathictomy and compensatory sweating in treatment of palmar hyperhidrosis. Chin Med J, 2007, 120(18): 1574-1577.
16.	劉彥國, 楊劼, 王俊, 等. T3、T4 交感神經鏈切斷術治療手汗癥的比較. 中華醫學雜志, 2006, 86(33): 2318-2320.
17.	伊嚴, 楊家恒, 崔經樂. 胸腔鏡下不同節段交感神經干切斷術治療手汗癥的隨機自身對照研究. 微創醫學, 2014, 9(1): 25-27.
18.	楊劼, 劉彥國, 譚家駒, 等. 不同位置胸交感鏈切斷治療手汗癥與術后代償性出汗的關系. 中國胸心血管外科臨床雜志, 2006, 13(5): 315-317.
19.	李達周, 陳飛, 陳煒生, 等. 經臍超細胃鏡 T3、T4 交感神經毀損術治療原發性手汗癥療效比較. 中華消化內鏡雜志, 2015, 32(11): 725-728.
20.	Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
21.	Rodriguez PM, Freixinet JL, Hussein M, et al. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients. Eur J Cardiothorac Surg, 2008, 34(3): 514-519.

1. ?張家衡, 陳奇, 陳宇鵬, 等. 電視胸腔鏡下 T_2、3 交感神經干切斷術治療手汗癥的療效觀察. 中國胸心血管外科臨床雜志, 2008, 15(5): 373.
2. 周冰, 嚴志焜, 朱理, 等. 胸腔鏡下胸交感神經切除術治療手汗癥 110 例. 中國胸心血管外科臨床雜志, 2003, 10(2): 134-135.
3. 張文雄, 徐建軍, 熊利華. 單孔電視胸腔鏡下交感神經切斷術治療手汗癥 48 例臨床分析. 中國胸心血管外科臨床雜志, 2015, 22(3): 220-224.
4. 任福強, 仇滔, 芮軍, 等. 胸腔鏡雙側腋下單切口胸交感神經鏈切斷術治療手汗癥. 中國胸心血管外科臨床雜志, 2015, 22(1): 54-56.
5. Chang YT, Li HP, Lee JY, et al. Treatment of palmar hyperhidrosis T4 level compared with T3 and T2. Ann Surg, 2007, 246(2): 330-336.
6. Yazbek G, Wolosker N, Kauffman P, et al. Twenty months of evolution following sympathectomy on patients with palmar hyperhidrosis: sympathectomy at the T3 level is better than at the T2 level. Clinics, 2009, 64(8): 743-749.
7. Yazbek G, Wolosker N, de Campos JR, et al. Palmar hyperhidrosis-which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion? J Vasc Surg, 2005, 42(2): 281-285.
8. 林敏, 涂遠榮, 李旭, 等. 不同節段胸交感神經干切斷術治療手汗癥的療效比較. 中華醫學雜志, 2006, 86(33): 2315-2317.
9. Cai S, Huang S, An J, et al. Effect of lowering or restricting sympathectomy levels on compensatory sweating. Clin Auton Res, 2014, 24(3): 143-149.
10. 葛明建, 吳慶琛, 李強, 等. 電視胸腔鏡胸交感干并旁路纖維切斷術治療手汗癥 355 例分析. 重慶醫科大學學報, 2010, 35(10): 1577-1579.
11. 池聞, 劉瑜, 林曉銘. 胸腔鏡下胸交感神經干切斷術治療原發性手汗癥臨床分析. 現代實用醫學, 2010, 22(11): 1229-1230.
12. Kim WO, Kil HK, Yoon KB, et al. Influence of T3 or T4 sympathicotomy for palmar hyperhidrosis. Am J Surg, 2010, 199(2): 166-169.
13. Ishy A, de Campos JR, Wolosker N, et al. Objective evaluation of patients with palmar hyperhidrosis submitted to two levels of sympathectomy: T3 and T4. Interact Cardiovasc Thorac Surg, 2011, 12(4): 545-548.
14. Liu Y, Yang J, Liu J, et al. Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy. Eur J Cardiothorac Surg, 2009, 35(3): 398-402.
15. Yang J, Tan JJ, Ye GL, et al. T3/T4 thoracic sympathictomy and compensatory sweating in treatment of palmar hyperhidrosis. Chin Med J, 2007, 120(18): 1574-1577.
16. 劉彥國, 楊劼, 王俊, 等. T3、T4 交感神經鏈切斷術治療手汗癥的比較. 中華醫學雜志, 2006, 86(33): 2318-2320.
17. 伊嚴, 楊家恒, 崔經樂. 胸腔鏡下不同節段交感神經干切斷術治療手汗癥的隨機自身對照研究. 微創醫學, 2014, 9(1): 25-27.
18. 楊劼, 劉彥國, 譚家駒, 等. 不同位置胸交感鏈切斷治療手汗癥與術后代償性出汗的關系. 中國胸心血管外科臨床雜志, 2006, 13(5): 315-317.
19. 李達周, 陳飛, 陳煒生, 等. 經臍超細胃鏡 T3、T4 交感神經毀損術治療原發性手汗癥療效比較. 中華消化內鏡雜志, 2015, 32(11): 725-728.
20. Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
21. Rodriguez PM, Freixinet JL, Hussein M, et al. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients. Eur J Cardiothorac Surg, 2008, 34(3): 514-519.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Postoperative effects of different thoracoscopic sympathectomy on palmar hyperhidrosis patients: A systematic review and meta-analysis

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