胸部交感神経切除術における手技の工夫とその利点

Clinical assessment and our idea for hyperhidrosis treatment

　胸部交感神経節切除術は多汗症の改善は得られるが，重大な副作用が生じ得ることを念頭におくべきである．特に，代償性発汗や手のひらの過度な乾燥などが術後に患者を苦しめる．この間題を解決するために，筆者らは胸部交感神経節切除術における切除部位および切除量と患者の長期経過を検討して手術の最適化をテーマに取り組んできた．部分切除術への取り組みの経緯と，ルーチンワークとして3,400例あまりに実施した日帰り手術のクリニカルパスについて述べた．

Endoscopic thoracic sympathectomy has many burdensome complications including compensatory sweating and excessive dryness in hand. To resolve these problems, we tried the partial resection of the thoracic sympa-thetic trunk in some patients. It was revealed that the level and the quantity of sympathetic trunk resection were related to the efficacy and side effects. In this paper, we reported the process of partial sympathectomy and our clinical pass of one-day surgery in the cases of more than 3,400 cases.