Tubeless video-assisted thoracoscopic surgery for primary palmar hyperhidrosis: A retrospective cohort study in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YI Changsheng ^1,2 , YUE Peng ¹ , HU Wenteng ¹ , YUE Hanxun ² , MA Minjie ¹ ,  HAN Biao ¹

1. Department of Thoracic Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P. R. China;
2. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P. R. China;

Corresponding?author：

HAN Biao, Email: hanbiao66@163.com

Keywords：

Primary palmar hyperhidrosis; tubeless video-assisted thoracoscopy; enhanced recovery after surgery

DOI：

10.7507/1007-4848.202010065

Video：

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Objective To explore the safety, feasibility and superiority of tubeless video-assisted thoracoscopy in the treatment of primary palmar hyperhidrosis (PPH).Methods The clinical data of 46 patients with palmar hyperhidrosis treated by thoracoscopy in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from March 2017 to September 2020 were retrospectively analyzed. Among them, 22 received tubeless video-assisted thoracoscopic surgery, and were divided into a tubeless group, including 10 males and 12 females with an average age of 24.3±6.4 years; 24 received conventional thoracoscopic surgery, and were divided into a control group, including 13 males and 11 females with an average age of 23.5±4.8 years. The operation status, anesthesia effect and postoperative complications of the two groups were compared.Results Forty-six patients successfully completed the operation with the assistance of thoracoscopy. There was no intraoperative transfer to thoracotomy, or intraoperative transfer to tracheal intubation in the tubeless group. Anesthetic recovery time (14.4±1.6 min vs. 20.1±1.8 min, P=0.000), time to get out of bed on the first postoperative day (3.1±0.6 h vs. 1.6±0.4 h, P=0.000), visual analogue score for postoperative pain (1.4±0.6 points vs. 3.4±1.1 points, P=0.000), postoperative hospital stay (1.7±0.5 d vs. 2.8±0.6 d, P=0.000), postoperative satisfaction rate of patients (95.5% vs. 66.7%, P=0.037) in the tubeless group were shorter or better than those in the control group. There was no statistical difference in age, gender, smoking history, palmar hyperhidrosis classification, palms or other associated parts, the total time of bilateral surgery, intraoperative blood loss, postoperative complications, or compensatory hyperhidrosis (mild) between the two groups (P>0.05).Conclusion Compared with traditional thoracoscopic surgery for PPH, tubeless video-assisted thoracoscopic surgery for PPH has the advantages of safety, reliability, light pain and quick recovery, in line with the concept of accelerated rehabilitation surgery.

Citation： YI Changsheng, YUE Peng, HU Wenteng, YUE Hanxun, MA Minjie, HAN Biao. Tubeless video-assisted thoracoscopic surgery for primary palmar hyperhidrosis: A retrospective cohort study in a single center. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(3): 318-322. doi: 10.7507/1007-4848.202010065 Copy

1.	Cui F, Liu J, Li S, et al. Tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively. J Thorac Dis, 2016, 8(8): 2226-2232.
2.	He J, Liu J, Zhu C, et al. Expert consensus on tubeless video-assisted thoracoscopic surgery (Guangzhou). J Thorac Dis, 2019, 11(10): 4101-4108.
3.	Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol, 2004, 51(2): 274-286.
4.	Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Etiology and clinical work-up. J Am Acad Dermatol, 2019, 81(3): 657-666.
5.	Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
6.	Lai FC, Tu YR, Li YP, et al. Nation wide epidemiological survey of primary palmar hyperhidrosis in the People's Republic of China. Clin Auton Res, 2015, 25(2): 105-108.
7.	Kamberov YG, Wang S, Tan J, et al. Modeling recent human evolution in mice by expression of a selected EDAR variant. Cell, 2013, 152(4): 691-702.
8.	車國衛. 加速康復外科—臨床應用加減之間? 中國肺癌雜志, 2019, 22(11): 681-686.
9.	Liu CY, Hsu PK, Leong KI, et al. Is tubeless uniportal video-assisted thoracic surgery for pulmonary wedge resection a safe procedure? Eur J Cardiothorac Surg, 2020, 58(Suppl_1): i70-i76.
10.	Pompeo E, Sorge R, Akopov A, et al. Non-intubated thoracic surgery —A survey from the European Society of Thoracic Surgeons. Ann Transl Med, 2015, 3(3): 37.
11.	沈誠, 常帥, 周坤, 等. 加速康復外科和日間手術模式在胸外科中的應用現狀及發展前景. 中國肺癌雜志, 2020, 23(9): 800-805.
12.	Miller DL, Force SD. Outpatient microthoracoscopic sympathectomy for palmar hyperhidrosis. Ann Thorac Surg, 2007, 83(5): 1850-1853.
13.	李冬, 沈琦斌, 陳超. 日間喉罩全麻聯合單孔胸腔鏡交感神經切斷術治療手汗癥效果觀察. 浙江醫學, 2019, 41(10): 1059-1061.
14.	岳瀚遜, 張瑜, 馬敏杰, 等. Tubeless經劍突下胸腔鏡前縱隔腫瘤切除手術的病例對照研究. 中國胸心血管外科臨床雜志, 2019, 26(4): 353-357.
15.	Li S, Jiang L, Ang KL, et al. New tubeless video-assisted thoracoscopic surgery for small pulmonary nodules. Eur J Cardiothorac Surg, 2017, 51(4): 689-693.
16.	Yang SM, Wang ML, Hung MH, et al. Tubeless uniportal thoracoscopic wedge resection for peripheral lung nodules. Ann Thorac Surg, 2017, 103(2): 462-468.

1. Cui F, Liu J, Li S, et al. Tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively. J Thorac Dis, 2016, 8(8): 2226-2232.
2. He J, Liu J, Zhu C, et al. Expert consensus on tubeless video-assisted thoracoscopic surgery (Guangzhou). J Thorac Dis, 2019, 11(10): 4101-4108.
3. Hornberger J, Grimes K, Naumann M, et al. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol, 2004, 51(2): 274-286.
4. Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: A comprehensive review: Etiology and clinical work-up. J Am Acad Dermatol, 2019, 81(3): 657-666.
5. Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
6. Lai FC, Tu YR, Li YP, et al. Nation wide epidemiological survey of primary palmar hyperhidrosis in the People's Republic of China. Clin Auton Res, 2015, 25(2): 105-108.
7. Kamberov YG, Wang S, Tan J, et al. Modeling recent human evolution in mice by expression of a selected EDAR variant. Cell, 2013, 152(4): 691-702.
8. 車國衛. 加速康復外科—臨床應用加減之間? 中國肺癌雜志, 2019, 22(11): 681-686.
9. Liu CY, Hsu PK, Leong KI, et al. Is tubeless uniportal video-assisted thoracic surgery for pulmonary wedge resection a safe procedure? Eur J Cardiothorac Surg, 2020, 58(Suppl_1): i70-i76.
10. Pompeo E, Sorge R, Akopov A, et al. Non-intubated thoracic surgery —A survey from the European Society of Thoracic Surgeons. Ann Transl Med, 2015, 3(3): 37.
11. 沈誠, 常帥, 周坤, 等. 加速康復外科和日間手術模式在胸外科中的應用現狀及發展前景. 中國肺癌雜志, 2020, 23(9): 800-805.
12. Miller DL, Force SD. Outpatient microthoracoscopic sympathectomy for palmar hyperhidrosis. Ann Thorac Surg, 2007, 83(5): 1850-1853.
13. 李冬, 沈琦斌, 陳超. 日間喉罩全麻聯合單孔胸腔鏡交感神經切斷術治療手汗癥效果觀察. 浙江醫學, 2019, 41(10): 1059-1061.
14. 岳瀚遜, 張瑜, 馬敏杰, 等. Tubeless經劍突下胸腔鏡前縱隔腫瘤切除手術的病例對照研究. 中國胸心血管外科臨床雜志, 2019, 26(4): 353-357.
15. Li S, Jiang L, Ang KL, et al. New tubeless video-assisted thoracoscopic surgery for small pulmonary nodules. Eur J Cardiothorac Surg, 2017, 51(4): 689-693.
16. Yang SM, Wang ML, Hung MH, et al. Tubeless uniportal thoracoscopic wedge resection for peripheral lung nodules. Ann Thorac Surg, 2017, 103(2): 462-468.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Tubeless video-assisted thoracoscopic surgery for primary palmar hyperhidrosis: A retrospective cohort study in a single center

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