Innovative Techniques for thoracic sympathectomy: Experience of 654 patients for essential hyperhidrosise

흉부 교감신경절 절제에 대한 수술기법의 변화

  • 문동석 (관동대학교 의과대학 흉부괴과학교실) ;
  • 이두연 (연세대학교 의과대학 영동세브란스병원 호흡기센터 흉부외과학교실) ;
  • 김해균 (연세대학교 의과대학 영동세브란스병원 호흡기센터 흉부외과학교실)
  • Published : 1998.07.01

Abstract

We treated 654 patients with simultaneous bilateral sympathectomy for essential hyperhidrosis from March 1989 to September 1997(354 males and 300 females). The exposure afforded by thoracoscopy is actually superior to that seen at the time of either thoracotomy or axillary thoracotomy. The use of single-lumen intubation with alternating partially collapsed lung by CO2 inflation resulted in shorter anesthesia, shorter operative time, and shorter hospitalization. 2-mm extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective one in the treatment of hyperhidrosis by experienced surgeons. The modification on our technique of thoracoscopic sympathectomy as described allowed us to significantly improve our previous results. A majority of the patients were relieved, and over 95% were satisfied initially.

연세대학교 의과대학 영동세브란스병원에서는 1989년 3월부터 1997년 9월까지 외래와 전화추적이 가능하였던 654명(남자 354명과 여자 300명)의 다한증 환자를 대상으로 흉부교감신경절제술을 시행하였다. 다한증에 대한 흉강 내시경을 이용한 수술기법은 기존의 개흉술보다 선명한 수술시야를 확보할 수 있는 장점이 있다. 단순기관 삽관을 이용한 마취 유도기법으로 마취시간의 단축과 수술시간의 단축, 그리고 입원기간의 단축이 가능하게 되었다. 시간절약뿐만 아니라 수술기법이 쉽고 미용효과를 최대로 살릴수 있는 2 mm주사침 흉강경을 이용한 흉부 교감신경 절제술은 최근 다한증에 가장 확실한 치료법이 되었다. 수술기법의 변화는 수술의 결과를 향상시켰으며, 수술 후 만족도를 95%이상으로 향상시켰다.

Keywords

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