手汗治療專家莊金順神經外科醫師_英文版介紹
Dr. King-Shun Chuang
A New Method of Percutaneous Stereotaxic Thermocoagulation
Of T3 or T4 for Palmar Hyperhidrosis: No Occurrence of Severe
Compensatory Hyperhidrosis.
Dr. King-Shun Chuang
Chuang King-Shun Neurosurgical Clinic, Kaohsiung, Taiwan.
PURPOSE:
Our previous study indicated that percutaneous stereotactic
thermocoagulation of the 2nd thoracic sympathectomy (T2) were
effective treatment for palmar hyperhidrosis (PH) that provided
excellent immediate and long-term results, as well as low
complication rates.
This treatment can cause severe compensatory hyperhidrosis
(CH). Recent articles advocated T3 or T4 sympathectomy for
PH to minimized CH. In this study, percutaneous stereotactic
thermocoagulalion of 3rd or 4th thoracic sympathectomy (T3 or
T4) was performed to treat PH. We investigated the occurrenceand
severity off CH.
METHOD AND RESULTS:
Between June 2011 and June 2015, percutaneous stereotaxic
thermocoagulation of T3 or T4 was performed in 127 Chinese
patients with palmar hyperhidrosis under local anesthesia. One
hundred ten patient were followed between one week to 17
months (mean 2.6 months) after the procedure.One hundred-two
patients (92.7%) had dry or nearly dry hand except 8 patients (7.3%)
had wet hand in T4 sympathectomy.
Ninety-six Patients (87.3%) had mild CH, 14 Patients (12.7%)
had moderate CH, and no patient had severe CH. Three hands
(1.4%) experienced recurrent PH and one side (0.45%)developed
pneumothorax in T4 sympathectomy. One hundred andseven
patients(97.3%) were satisfied with the outcome except 3 patients
(2.7%)were partially satisfied due to wet hand in T4 sympathectomy.
No patient expressed regret.
CONCLUSION:
Percutaneous Stereotaxic thermocoagulation of T3 or T4 is a
safe and effective treatment for palmar hyperhidrosis. This
method had also no occurrence of severe compensatory hyperhidrosis.
ACKNOWLEDGMENT:
The preliminary results presented at 15th world congress of
neurosurgery in Seoul, South Korea on September 12, 2013,
11th congress of the Neurosurgical society in Taichung, Taiwan
on December 1, 2013 and BIT's 5th Annual World congress of
NeuroTalk in Nanjing, China on May 18, 2014.
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