| ?Objective?This meta-analysis is aimed to systematically evaluate the effect of different segments sympathectomy in surgical treatment of palmar hyperhidrosis. So as to provide preference for the manipulative optinal segments in surgery.?Methods?A systematic search of published literature was performed on Pub Med database from their date of inception to November 2015. We selected relevant literatures which compared the effect of different segments sympathectomy with postoprative compensatory hyperhidrosis as the evaluation index. A combination of computer retrieval and manual retrieval was applied. The quality of included literatures was assessed according to the method provided by the Cochrane systematic review(5.1.0 version). Meta-analysis was performed by using the Cochrane Collaboration,s Review Manager 5.3.?Results?Our meta-analysis included 11 randomized controlled trials and 4 retrospective studies. Compared the effect of different segments sympathectomy, T3-4 had a lower incidence rate of postoprative compensatory hyperhidrosis than T2-4[RR=1.95,95%CI(1.38,2.74),P= 0.0001], T3 was more effective than T2 [RR=1.81, 95%CI(1.10,2.98), P=0.02], T4 was more effective than T3 [RR=2.98,95%CI(2.05,4.33),P<0.00001]. There was no statistical difference bettween single-segment and multiple-segment ablation.?Conclusion?Video-assisted thoracoscopic sympathectomy has been proved to be a safe and effective way to treat palmar hyperhidrosis. According to our analysis multiple-segment sympathectomy on T3-4 is more effective than others. Single-segment sympathectomy on T4 is more effective than the others. There has no obvious difference between multiple-segment and single-segment sympathectomy, nevertheless the latter one makes a lower incidence of compensatory hyperhidrosis. According to the general trend of the graph distribution, we infer that T4 segment sympathectomy could effectively reduce the incidence of compensatory hyperhidrosis. |
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