The feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis
- VernacularTitle:高清胸腔镜在原发性手汗症胸交感神经切断术中识别神经节的可行性研究
- Author:
Gang XU
1
;
Chaoyue HU
1
;
Cong CHEN
1
;
Yuancai LIN
1
;
Daolong ZHU
1
;
Han LIU
1
;
Dong WANG
1
Author Information
1. Department of Thoracic Surgery, Taikang Xianlin Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210023, P. R. China
- Publication Type:Journal Article
- Keywords:
Palmar hyperhidrosis;
high-definition thoracoscopy;
sympathicotomy;
sympathetic ganglion;
near-infrared fluorescence;
indocyanine green;
feasibility study
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(04):578-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.
