Endoscopic Thoracic Sympathectomy and its Anesthesia Method in our Department

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概要

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• We experienced 69 cases of the endoscopic thoracic sympathectomy, ETS, for the cases indicated for the alcohol block of the sympathetic nerve during period of November, 1993 to July, 1997. We successfully carried out for the safe, less-invasive and simple practice of surgical and anesthetic techniques on these cases.Instead of the special endotracheal tube for one lung ventilation, we used common single-lumen endotracheal tube. Superimposing of high frequency jet ventilation during operation is remarkable for our anesthetic technique.The ETS is performed using thorocar with 3mm of diameter by the two-ports technique.Sufficient view were obtained by purposeful pneumothorax with filtered air. The sympathetic block was performed by the coagulation using electric cautery or YAG laser. For essential hyperhidrosis, bilateral ETS was completed at a time. Neither of intrathoracic drainage nor skin suture was made.The curative effect of 63 cases, that is 122 procedures of essential hyperhidrosis was summarized as follows.Complete inhibition of the palmar perspiration was obtained in all cases. For the axillary perspiration, forty five of 63 cases (71%) valued exellent and eighteen (29%) good. None of the less effective was experienced in the case of axillary perspiration treatment. For the plantar perspiration, exellent, good, and less effective were found 15 cases (24%), 27 cases (43%) and 21 cases (33%) out of 63 cases, respectively. We experienced complications of the pneumothorax (3 cases), subcutaneous emphysema (2 cases) and allodynia (4 cases). The compensatory perspiration was found in many cases.

• 一般社団法人 日本ペインクリニック学会の論文

一般社団法人 日本ペインクリニック学会 | 論文

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