單孔腹腔鏡交感神經切除術在治療腳汗症的長期療效

李齊泰、戴定恩、周安琪、林敬哲、吳志寬、蔡曜州

臺北醫學大學附設醫院 泌尿科；

Long-term outcome of Laparoendoscopic single-site retroperitoneal lumbar sympathectomy for plantar hyperhidrosis

Chi-Tai Li¹, Ting-En Tai¹, An-Chi Chou¹, Ching-Che Lin¹, Chih-Kuan Wu¹ Yao-Chou Tsai^1,2

¹Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan

²Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

Purpose:

Endoscopic lumbar sympathectomy becomes a popular option for treating plantar hyperhidrosis after failure of conservative treatment. The aim of this study was to evaluate the effectiveness and safety of laparoendoscopic single-site surgery (LESS) retroperitoneal lumbar sympathectomy (RLS).  

Materials and Methods:

 From March 2010 to August 2020, we reviewed 6 men and 6 women who received LESS RLS with mean follow-up of 44.2 months (1-125). Preoperative and postoperative plantar sweating was evaluated by Hyperhidrosis Disease Severity Scale (HDSS). Other clinical results including satisfaction and perioperative complications were also recorded.

Results:

All patients underwent LESS RLS without shifting to other approach techniques. Mean operation time was 143 minutes (90-190). All patient’s HDSS downgraded from 4 to 1 and no recurrence noted during follow-up. The mean of operation satisfaction score (1-10) was 9.1. Compensatory sweating was 80% and the dominant regions were chest (50%) and back (50%), other including head 2(25%), neck 2(25%), hand 1(12.5%) but only two patients had severe compensatory sweating (25%). There was no neuralgia nor any other complication. Also, no ejaculation dysfunction was noted in all male patients.

Conclusion:

LEES RLS is not only a feasible and safe option for plantar hyperhidrosis but also has better cosmetic outcome than traditional endoscopic lumbar sympathectomy.