A comparative study of subxiphoid uniportal video-assisted thoracoscopic surgery and uniportal bilateral video-assisted thoracoscopic surgery on palmar hyperhidrosis

doi:10.3877/cma.j.issn.2095-8773.2019.03.05

Abstract

Abstract:

Objective

The Purpose of this paper is to study the advantages and disadvantages of subxiphoid uniportal video-assisted thoracoscopic surgery and uniportal bilateral video-assisted thoracoscopic surgery on palmar hyperhidrosis ,and to evaluate their efficacy and safety .

Methods

From April of 2016 to June of 2018 we consecutively admitted 80 patients with Palmar Hyperhidrosis ,in which 17 are males ,63 are females .Then we used the method of random number table to divided them into two groups :subxiphoid uniportal group and uniportal bilateral group .Those data including the total surgery time ,surgery operation time ,grade of wound healing ,the levels of pain on numerical rating scale during the first 24 hours and one week after surgery(Numeric Rating Scale , NRS) , grade of compensatory sweating ,pulmonary complications ,postoperative hospital stay and follow-up time after surgery of the two groups were recorded and analyzed .

Results

There was no significant difference on total surgery time , surgery operation time , grade of wound healing , compensatory hyperhidrosis , pulmonary complications ,postoperative hospital stay and follow-up time after surgery between the two groups( P＞0 .05) . Compared with Uniportal bilateral group , NRS of subxiphoid uniportal group was obviously decreased within the first 24 hours and one week after surgery .The difference was with statistically significance( P＜0 .05) .

Conclusions

Compared with uniportal bilateral video-assisted thoracoscopic surgery for palmar hyperhidrosis , subxiphoid uniportal video-assisted thoracoscopic surgery shows certain superiority on relieving postoperative pain , thus patients benefit more . Therefore , it is recommended to perform Subxiphoid uniportal video-assisted thoracoscopic surgery in the treatment of palmar hyperhidrosis .

Key words: Subxiphoid uniportal video-assisted thracoscopic surgery, Uniportal bilateral videoassisted thoracoscopic surgery, Palmar Hyperhidrosis, Pain

Baolei Liang, Hao Wei, Linxia Xu, Ke Shi, Changhai Shao, Xixian Ke, Qingyong Cai. A comparative study of subxiphoid uniportal video-assisted thoracoscopic surgery and uniportal bilateral video-assisted thoracoscopic surgery on palmar hyperhidrosis[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2019, 06(03): 161-165.

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URL: https://zhxbwkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8773.2019.03.05

https://zhxbwkdzzz.cma-cmc.com.cn/EN/Y2019/V06/I03/161

Figures/Tables 4

组别	年龄(岁， $\bar{x}$ ±ｓ）	性别［ｎ（％）］）		手汗症程度［ｎ（％）］		肺部合并症［ｎ（％）］
组别	年龄(岁， $\bar{x}$ ±ｓ）	男性	女性	中等	重度	陈旧性结核	肺炎
剑突下单孔胸腔镜组（ｎ＝40）	18.8±2.4	10（25.0）	30（75.0）	15（37.5）	25（62.5）	2（5.0）	1（2.5）
双侧单孔胸腔镜组（ｎ＝40）	19.6±3.1	7（17.5）	33（82.5）	20（50.0）	20（50.0）	3（7.5）	3（7.5）
ｔ／χ²值	ｔ＝－1.212	χ²＝0.672		χ²＝0.813		χ²＝0.000	χ²＝0.263
Ｐ值	0.229	0.412		0.367		1	0.608

组别	年龄(岁， $\bar{x}$ ±ｓ）	性别［ｎ（％）］）		手汗症程度［ｎ（％）］		肺部合并症［ｎ（％）］
组别	年龄(岁， $\bar{x}$ ±ｓ）	男性	女性	中等	重度	陈旧性结核	肺炎
剑突下单孔胸腔镜组（ｎ＝40）	18.8±2.4	10（25.0）	30（75.0）	15（37.5）	25（62.5）	2（5.0）	1（2.5）
双侧单孔胸腔镜组（ｎ＝40）	19.6±3.1	7（17.5）	33（82.5）	20（50.0）	20（50.0）	3（7.5）	3（7.5）
ｔ／χ²值	ｔ＝－1.212	χ²＝0.672		χ²＝0.813		χ²＝0.000	χ²＝0.263
Ｐ值	0.229	0.412		0.367		1	0.608

组别	手术时间（min）	术中操作时间（min）	术后住院时间（d）	随访时间（月）
剑突下单孔胸腔镜组（n=40）	47.8±8.9	33.8±8.6	1.2±0.7	9.5±2.8
双侧单孔胸腔镜组（n=40）	43.9±9.1	31.2±8.1	1.2±0.6	10.0±2.1
t值	1.941	1.394	0.176	-1.053
P值	0.056	0.167	0.861	0.295

组别	24hNRS			1周NRS			切口愈合等级			代偿性多汗等级			肺部并发症
组别	轻度	中度	重度	轻度	中度	重度	甲级	乙级	丙级	甲级	乙级	丙级	肺膨胀不全	胸腔积液	肺炎
剑突下单孔胸腔镜组（n=40）	32	8	0	36	4	0	32	6	2	12	2	0	3	3	4
双侧单孔胸腔镜组（n=40）	16	20	4	30	8	2	37	2	1	14	4	0	4	2	5
Z/χ²值	Z=-3.756			Z=-6.743			Z=-1.594			Z=-0.562			χ²=0.000	χ²=0.000	χ²=0.000
P值	＜0.001			＜0.001			0.111			0.722			1.000	1.000	1.000

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