A Randomized Controlled Trial: Single-Port Needles-Copic Versus Traditional Single-Port Endoscopic Thoracic Sympathyectomy For Primary Palmar Hyperhidrosis

Objective To evaluate the effectiveness 、Cosmetic effect and Satisfaction of needlescopic single-port needlescopic endoscopic thoracic sympathectomy for primary palmar hyperhidrosis. Methods From January 2012 to January 2014, a total of 268 patients with PPH,received ETS in The First Affiliated Hospital of Fujian Medical University,were recruited into the study and randomly assigned to two groups: 148 patients received needlescopic single-port ETS using 3 mm needle scope, 2 mm cautery hook and 3.3 mm trocar(needlescopic group),and 120 patients received traditional single-port ETS using 5 mm thoracoscope, 5 mm cautery hook and 6 mm trocar(traditional group). All patients were followed up and evaluated for comparison of mean operative time, postoperative pain,Cosmetic effect, cosmetic effects, satisfaction and postoperative complications between the two groups. Results The operations were successful in all patients.There was no serious complication and death patients.All patients were followed up,the mean postoperative follow-up period was 23.6 months. The compared result:After surgery the hands of all patients became dry and warm, The effective rate was 100%. Mean incision size was 4.13±1.69 mm in the needlescopic group and 10.33±2.52 mm in the traditional group(p < 0.05).The mean operation time was 13.97±5.12 mm in the needlescopic group and 15.36±4.71 mm in the traditional group(p > 0.05). The mean pain score was 2.5±1.1 with 2 mm needle scope and 6.4±1.9 with 5 mm thoracoscope(p < 0.01). Two groups of patients are satisfied with the cosmetic results of the incision. In needlescopic group,patients who felt very satisfied was accounting for 96.6 %(143/148) and those feeling satisfied is accounting for 3.4%( 5/148).While in traditional group,patients who felt very satisfied was accounting for 80.8%(97 /120) and those feeling satisfied is accounting for 19.2%(23/120).The satisfaction between the two groups is statistically significant(P < 0.05).There were no significant differences between the two procedures for postoperative complications(Pneumothorax and Compensatory hyperhidrosis)(p > 0.05). The overall satisfaction after operation was 84.5 %(125 / 148) in the needlescopic group and 68.3 %(82 / 120)in the traditional group,The result is statistically significant(p < 0.01). Conclusion Endoscopic thoracic sympathectomy with needlescopic single-port trocar for primary palmar hyperhidrosis is more minimally invasive, less postoperative pain, more beautiful incision,much higher postoperative satisfaction and more worthy clinical promoted application.It should be extended to the normal operation mode.