Primer Hiperhidroz: Torakoskopik Torakal Sempatektomi

Abstract

Amaç: Primer hiperhidroz, ter bezlerinin aktivitesinde artışa neden olan, renk değişikliğine ve terlemeye yol açan tıbbi bir bozukluktur. Her iki cinsiyet de eşit derecede etkilenir ve semptomlar genellikle 14 ile 25 yaşları arasında ortaya çıkar. Aksiller, palmar, plantar veya yaygın olabilir. Hastalar sıklıkla sosyal ortamlardan kaçınır ve iş hayatları aksayabilir. Birçok tedavi yöntemi denenmiştir, ancak cerrahi bir işlem olan sempatektomi en etkili olanıdır. Sempatektomi, sempatik sinirin kesilmesi veya sıkıştırılmasını içeren cerrahi bir işlemdir. Bu çalışmada, sempatektomi ile ilgili deneyimlerimizi paylaşmak istedik. Yöntem: Ocak 2024 ile Ocak 2025 tarihleri arasında, aşırı terleme şikayetiyle polikliniğimize toplam 32 hasta başvurdu. Sempatektomi uygulanan 10 hasta, kullanılan cerrahi yaklaşım, hastanede kalış süresi, komplikasyonlar ve cerrahi başarı açısından değerlendirildi. Bulgular: Tüm hastalara primer hiperhidroz nedeniyle bilateral torakoskopik torasik sempatektomi uygulandı. En yaygın neden ellerde aşırı terleme, ardından her iki el ve koltuk altlarında aşırı terleme ve son olarak sadece koltuk altlarında aşırı terleme idi. Takip sürecinin ilk haftasında bir hasta port bölgesinde ağrıdan şikayet ederken, diğer tüm hastaların lokal aşırı terleme şikayetleri azalmıştı. Hastalar takip sürecinin ilk ayı veya yılı boyunca herhangi bir sorun bildirmediler. Tartışma: Hiperhidroz, insanların sosyal yaşamlarını etkileyen stresle ilişkili bir hastalıktır. Hastaların ailelerinin %30-65’inde görülmesi kalıtsal bir temeli olduğunu göstermektedir. Torakoskopik torasik sempatektomi, tıbbi tedaviye yanıt vermeyen veya tıbbi tedavinin farkında olan ve kalıcı bir çözüm isteyen hiperhidrozlu hastalarda geçerli kabul edilen etkili bir tedavi yöntemidir. Sonuç: Tek port kullanılarak yapılan torakoskopik torasik sempatektomi güvenli, pratik ve başarılı bir yöntem gibi görünmektedir.

Keywords

• Primer hiperhidroz
• Sempatektomi
• Torakoskopik torasik sempatektomi

Primer Hyperhidrosis: Thoracoscopic Thoracal sympathectomy

Abstract

Objective: Primary hyperhidrosis is a medical disorder that causes increased sweat gland activity, leading to discolouration and sweating. Both genders are equally affected, and symptoms often appear between the ages of 14 and 25. It may be axillary, palmar, plantar, or widespread. Patients frequently avoid social engagements, and their work lives can be disturbed. Many treatment methods have been tried, but sympathectomy, a surgical procedure, is the most effective one. Sympathectomy is a surgical operation that involves cutting or clamping the sympathetic nerve. In this study, we wanted to share our experience with sympathectomy. Method: Between January 2024 and January 2025, a total of 32 patients came to our outpatient clinic with excessive perspiration. Ten patients who underwent sympathectomy were evaluated based on the surgical approach employed, length of hospital stay, complications, and surgical success. Result: All patients underwent bilateral thoracoscopic thoracic sympathectomy due to primary hyperhidrosis. The most common reason for referral was excessive sweating in the hands, followed by both hands and armpits, and finally only in the armpits. During the first week of follow-up, one patient complained pain at the port site, whereas all other patients’ complaints of local excessive sweating had subsided. Patients reported no concerns throughout the first month or year of follow-up. Discussion: Hyperhidrosis is a stress-related illness that impacts people’s social lives. Its presence in 30-65% of patients’ families indicates a hereditary basis. Thoracoscopic thoracic sympathectomy is an effective treatment procedure that is regarded as valid in patients with hyperhidrosis who do not react to medical treatment or who are aware about medical treatment and want a permanent solution. Conclusion: Thoracoscopic thoracic sympathectomy using a single port seems to be a safe, practical, and successful method.

Keywords

• Primary hyperhidrosis
• Sympathectomy
• Thoracoscopic thoracic sympathectomy

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