Hiperhidroz tedavisinde sempatektomi: Etkin bir çözüm yolu mu?

Öz

Amaç: Primer hiperhidrozis, genel popülasyonun %1-3'ünü etkiler ve her iki cinsiyette de eşit oranda görülür. Yaşam kalitesini önemli ölçüde etkilemektedir. Son yıllarda, özellikle tek port yaklaşımıyla endoskopik torasik sempatektomi (ETS), primer hiperhidrozisin tedavisinde popülerlik kazanmıştır. Bu çalışma primer hiperhidrozisde ETS ameliyatının etkinliğini ve klinik sonuçlarını değerlendirmeyi amaçlamaktadır. Materyal ve Metot: Primer hiperhidrozis nedeniyle iki taraflı ETS uygulanan 30 hastanın verileri geriye dönük olarak incelendi. Çalışmaya tek port yaklaşımıyla tedavi edilen 25 hasta dahil edildi, çift port uygulanan 5 hasta çalışma dışı bırakıldı. Ameliyat öncesi değerlendirmeler ve rutin testler yapıldı. Hastalar yaş, cinsiyet, komplikasyonlar, memnuniyet, kompansatuvar terleme ve nüks açısından değerlendirildi. Hastaların memnuniyet düzeyleri telefon görüşmesi ile belirlendi. Bulgular: Ortalama hasta yaşı 24,16 ± 6,01 idi; %56'sı erkek ve %44'ü kadındı. Komplikasyon olarak hastaların %12’sinde kompansatris hiperhidrozis ve %12’sinde hafif pnömotoraks görüldü. Operatif mortalite meydana gelmedi. Uzun süreli takipte herhangi bir nüks görülmedi. Telefon anketlerinde hastaların %88'i memnuniyet bildirdi. Kompansatuvar terleme olan üç hasta kısmen memnundu. Hiçbir hasta pişmanlık bildirmedi. Sonuç: Primer hiperhidrozis tedavisinde kompansatuvar terleme riskine rağmen düşük morbidite ve yüksek hasta memnuniyet oranları ile ETS'nin etkili bir seçenek olduğuna inanıyoruz

Anahtar Kelimeler

• Hiperhidroz
• Endoskopik Torasik Sempatektomi
• Kompansatuar Terleme

Sympathectomy in the treatment of hyperhidrosis: Is it an effective solution?

Öz

Background: Primary hyperhidrosis affects 1-3% of the general population and occurs equally in both genders. It significantly affects the quality of life. In recent years, endoscopic thoracic sympathectomy (ETS), especially with a single-port approach, has gained popularity in the treatment of primary hyperhidrosis. This study aims to assess the efficacy and clinical outcomes of ETS surgery for primary hyperhidrosis. Materials and Methods: The data of 30 patients who underwent bilateral ETS due to primary hyperhidrosis were examined retrospectively. 25 patients treated with a single port approach were included in the study, and 5 patients treated with a double port approach were excluded from the study. Preoperative evaluations and routine tests were performed. Patients were evaluated in terms of age, gender, complications, satisfaction, compensatory sweating, and relapse. Patients' satisfaction levels were determined by telephone interviews. Results: The mean patient age was 24.16 ± 6.01 years; 56% were men and 44% were women. As complications, compensatory hyperhidrosis was observed in 12% of the patients, and mild pneumothorax was observed in 12%. No operative mortality occurred. No recurrence was observed during the long-term follow-up. In telephone surveys, 88% of patients reported satisfaction. Three patients with compensatory sweating were partially satisfied. No patient reported regret. Conclusions: We believe that ETS is an effective option in the treatment of primary hyperhidrosis, with low morbidity and high patient satisfaction rates, despite the risk of compensatory sweating.

Anahtar Kelimeler

• Hyperhidrosis
• Endoscopic Thoracic Sympathectomy
• Compensatory sweating.

Kaynakça

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