초록접수 현황
| 20F-005 | 구연 발표 |
Recent Experience of Thoracoscopic Sympathetic Block to Predict Compensatory Hyperhidrosis in Primary Hyperhidrosis
Jun Lee1, Jin Yong Jeong1, Jong Hui Suh1, Chan Beom Park1, Hana Kwoun2, Soo Seog Park2
1Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2Department of Anesthesiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Purpose : Compensatory hyperhidrosis is the cause of patients’ dissatisfaction after the sympathectomy for primary hyperhidrosis. To predict the occurrence of compensatory hyperhidrosis for patients, we performed a local anesthetic predictive procedure.
Methods : From March 2017 to November 2019, 107 patients underwent predictive procedures for primary palmar and craniofacial hyperhidrosis using 2-mm needlescope. A week later, the patients were interviewed and decided whether to proceed with sympathectomy.
Results : Primary hyperhidrosis was relieved in all patients by the predictive procedure without severe complications. Compensatory hyperhidrosis happened to 32 patients. Seventy-eight patients decided to undergo sympathectomy (group A) and twenty-nine patients refused the sympathectomy (group B). Group B tended to have higher average BMI (24.5 versus 23.2, p = 0.107) and compensatory hyperhidrosis rate (37.9% versus 26.9%, p = 0.269) compared to group A. The effective duration of sympathetic block was significantly longer in group A than in group B, which might be one of important factors for deciding to have surgery for patients (33.5 versus 13.9 hours, p = 0.001). The predictive procedure had 94.4% specificity and 33.3% sensitivity for prediction of compensatory hyperhidrosis.
Conclusion : We performed predictive procedure which gave an opportunity for the patient to experience the effect of sympathectomy on primary hyperhidrosis and occurrence of compensatory hyperhidrosis. And we concluded that thoracoscopic sympathetic block might be safe and feasible procedure to predict compensatory hyperhidrosis before sympathectomy. However, longer effective duration of sympathetic block is needed to help patients to decide whether to proceed with the surgery.
Methods : From March 2017 to November 2019, 107 patients underwent predictive procedures for primary palmar and craniofacial hyperhidrosis using 2-mm needlescope. A week later, the patients were interviewed and decided whether to proceed with sympathectomy.
Results : Primary hyperhidrosis was relieved in all patients by the predictive procedure without severe complications. Compensatory hyperhidrosis happened to 32 patients. Seventy-eight patients decided to undergo sympathectomy (group A) and twenty-nine patients refused the sympathectomy (group B). Group B tended to have higher average BMI (24.5 versus 23.2, p = 0.107) and compensatory hyperhidrosis rate (37.9% versus 26.9%, p = 0.269) compared to group A. The effective duration of sympathetic block was significantly longer in group A than in group B, which might be one of important factors for deciding to have surgery for patients (33.5 versus 13.9 hours, p = 0.001). The predictive procedure had 94.4% specificity and 33.3% sensitivity for prediction of compensatory hyperhidrosis.
Conclusion : We performed predictive procedure which gave an opportunity for the patient to experience the effect of sympathectomy on primary hyperhidrosis and occurrence of compensatory hyperhidrosis. And we concluded that thoracoscopic sympathetic block might be safe and feasible procedure to predict compensatory hyperhidrosis before sympathectomy. However, longer effective duration of sympathetic block is needed to help patients to decide whether to proceed with the surgery.
책임저자: Jin Yong Jeong
Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
발표자: Jin Yong Jeong, E-mail : jeong74@catholic.ac.kr