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Treatment of palmar and axillary hyperhidrosis by means of thoracoscopic sympathectomy : outcomes and complicatoins

علاج فرط تعرق راحتي اليدين و الإبطين بتقنية خزع السلسلة الودية الصدرية بالتنظير: نتائج و مضاعفات

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 Publication date 2015
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The aim of this study is to evaluate the thoracoscopic sympathectomy as a mini-invasive surgical procedure for the treatment of palmar and axillary hyperhidrosis. 39 patients were involved in this study. The ages were ranging between (17_45) years. 78 surgical procedures were performed for these patients. Every patient underwent simultaneously -in the same op-sitting-bilateral thoracoscopic sympathectomies T2-T4 . Succass rate, i.e , abscence of axillary and palmar hyperhidrosis, was 100%. The most discomfortable complicantion for the patients was compensatory sweating which happend in 28% of our patients. The reuslts we achieved were very encouraging and promising , and the complications were acceptable. Therefor we advice to continue the applicatin of thoracoscopic sympathectomy T2-T4 as an ideal methode for treatment of palmar and axillary hyperhidrosis.


Artificial intelligence review:
Research summary
تهدف هذه الدراسة إلى تقييم فعالية تقنية خزع السلسلة الودية الصدرية بالتنظير كعلاج لحالات فرط تعرق راحتي اليدين والإبطين. شملت الدراسة 39 مريضًا تتراوح أعمارهم بين 17 و45 عامًا، حيث خضع كل مريض لعمليتين جراحيتين في نفس الجلسة. بلغت نسبة النجاح 100% في غياب التعرق في راحتي اليدين والإبطين، بينما كانت المضاعفة الأكثر شيوعًا هي التعرق المعاوض في الجذع بنسبة 28%. كانت النتائج مشجعة والمضاعفات مقبولة، مما دفع الباحثين إلى التوصية باعتماد هذه التقنية كعلاج مثالي لحالات فرط تعرق راحتي اليدين والإبطين. تم إجراء العمليات في مشفى الأسد الجامعي بجامعة تشرين بين عامي 2008 و2014، وتمت متابعة المرضى لمدة عام كامل بعد الجراحة. كانت مدة البقاء في المستشفى قصيرة، حيث بقي المرضى يومًا واحدًا فقط. من المضاعفات التي حدثت: متلازمة هورنر العابرة، انصباب جنب بسيط، وآلام وربية. لم يحدث استرواح صدر أو انتان جرح. تقترح الدراسة استخدام أدوات صغيرة القطر لتقليل الآلام الوربية ووضع مغجر صدر روتينيًا لكل المرضى.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة لأنها تقدم حلاً فعالاً لمشكلة فرط التعرق التي تؤثر بشكل كبير على جودة حياة المرضى. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبيًا (39 مريضًا) مما قد يؤثر على تعميم النتائج. ثانيًا، لم يتم ذكر تفاصيل كافية حول المتابعة طويلة الأمد للمرضى بعد الجراحة، مما يجعل من الصعب تقييم الفعالية على المدى البعيد. ثالثًا، لم يتم مقارنة هذه التقنية بطرق علاجية أخرى بشكل مباشر، مما قد يساعد في تحديد مدى تفوقها على البدائل المتاحة. وأخيرًا، يجب أن تكون هناك دراسات إضافية تشمل عينات أكبر وتقييمات طويلة الأمد لتأكيد النتائج.
Questions related to the research
  1. ما هي نسبة النجاح في علاج فرط تعرق راحتي اليدين والإبطين باستخدام تقنية خزع السلسلة الودية الصدرية بالتنظير؟

    بلغت نسبة النجاح 100% في غياب التعرق في راحتي اليدين والإبطين.

  2. ما هي المضاعفة الأكثر شيوعًا بعد إجراء خزع السلسلة الودية الصدرية بالتنظير؟

    المضاعفة الأكثر شيوعًا هي التعرق المعاوض في الجذع بنسبة 28%.

  3. كم كانت مدة بقاء المرضى في المستشفى بعد الجراحة؟

    كانت مدة بقاء المرضى في المستشفى يومًا واحدًا فقط.

  4. ما هي التوصيات التي قدمتها الدراسة لتحسين نتائج الجراحة وتقليل المضاعفات؟

    توصي الدراسة باستخدام أدوات صغيرة القطر لتقليل الآلام الوربية ووضع مغجر صدر روتينيًا لكل المرضى.


References used
Kux E : The endoscopic appraoch to the vegetative nervous system and its therapeutic possibilities. Dis cheast 20 : 139 - 147 , 1951
Ahn SS , Machleder HI , et al : thorocoscopic cervicodorsal sympathectomy. J Vasc Surg 20 : 511 - 519 , 1994
Dumont P , Hamm A , Skrobala D , et al : Bilateral thoracoscopy for sympathectomy in the treatment of hyperhidrosis . Eur J Cardiothorac Surg 11 : 774 - 775 , 1997
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