Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 TU Yuanrong ^1,2 ,  LIU Yanguo ³ ,  CHEN Jianfeng ^1,2 , Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee , Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee

1. Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, P. R. China;
2. Department of Thoracic Surgery, The First Affiliated Hospital of Fujian Medical University (Binhai Campus), National Regional Medical Center, Fuzhou, 350212, P. R. China;
3. Department of Thoracic Surgery, Peking University People's Hospital, Beijing, 100044, P. R. China;

Corresponding?author：

TU Yuanrong, Email: tuyuanrong@hotmail.com; LIU Yanguo, Email: 2291058986@qq.com; CHEN Jianfeng, Email: 282781840@qq.com

Keywords：

Palmar hyperhidrosis; endoscopic thoracic sympathicotomy/sympathotomy; day surgery; quality control; expert consensus

DOI：

10.7507/1007-4848.202409064

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Endoscopic thoracic sympathicotomy/sympathotomy (ETS) is the first-line treatment for palmar hyperhidrosis with best minimally invasive effect. In recent years, with the widespread development of ETS in the treatment of palmar hyperhidrosis, many medical centers list ETS surgery as the day surgery. Nevertheless, there is no expert consensus on medical quality control of day surgery for ETS yet. Therefore, the Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee, Sympathetic Neurosurgery Expert Committee of WU Jieping Medical Foundation, and Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee organized domestic experts to conduct repeated consultations and sufficient discussions based on domestic and foreign literatures, to formulate the "Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis". It aims to provide a reference for the clinical diagnosis and treatment of palmar hyperhidrosis for thoracic surgery colleagues in our country, to enhance their management level and work efficiency, and ultimately to achieve standardized quality control.

Citation： TU Yuanrong, LIU Yanguo, CHEN Jianfeng, Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee, Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee. Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(1): 8-13. doi: 10.7507/1007-4848.202409064 Copy

1.	蔡林生, 余揚, 寧顯谷, 等. 日間手術模式下胸腔鏡胸交感神經切斷術治療手汗癥的安全性和可行性. 中國胸心血管外科臨床雜志, 2023, 30(2): 280-285.Cai LS, Yu Y, Ning XG, et al. Safety and feasibility of thoracic sympathectomy in the treatment of primary palmar hyperhidrosis based on ambulatory surgery. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(2): 280-285.
2.	曹守強, 董慶, 韓敬泉, 等. 日間手術治療手汗癥的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(6): 537-541.Cao SQ, Dong Q, Han JQ, et al. Day surgery for palmar hyperhidrosis: A case control study. Chin J Clin Thorac Cardiovasc Surg, 2016, 23(6): 537-541.
3.	賀海奇, 趙恒, 馬磊, 等. 基于加速康復外科理念手汗癥日間手術安全性與可行性的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2023, 30(11): 1556-1560.He HQ, Zhao H, Ma L, et al. The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery: A retrospective cohort study. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(11): 1556-1560.
4.	李冬, 沈琦斌, 陳超. 日間喉罩全麻聯合單孔胸腔鏡交感神經切斷術治療手汗癥效果觀察. 浙江醫學, 2019, 41(10): 1059-1061.Li D, Shen QB, Chen C. Observation of the effect of day surgery on laryngeal mask anesthesia combined with single port thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis. Zhejiang Med J, 2019, 41(10): 1059-1061.
5.	Sang HW, Li GL, Xiong P, et al. Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: An updated systematic review. Surg Endosc, 2017, 31(11): 4357-4369.
6.	Woo W, Kim BJ, Kang DY, et al. Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy. Surg Endosc, 2022, 36(11): 8340-8348.
7.	Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
8.	涂遠榮, 楊劼, 劉彥國. 中國手汗癥微創治療專家共識. 中華胸心血管外科雜志, 2011, 27(8): 449-451.Tu YR, Yang J, Liu YG. Expert consensus on minimally invasive treatment of palmar hyperhidrosis in China. Chin J Thorac Cardiovasc Surg, 2011, 27(8): 449-451.
9.	涂遠榮, 劉彥國. 中國手汗癥微創治療臨床指南(2021年版). 中國胸心血管外科臨床雜志, 2021, 28(10): 1133-1139.Tu YR, Liu YG. Clinical guideline for minimally invasive treatment of palmar hyperhidrosis in China (2021). Chin J Clin Thorac Cardiovasc Surg, 2021, 28(10): 1133-1139.
10.	Liu Y, Weng W, Tu Y, et al. Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version). Chin Med J (Engl), 2022, 135(11): 1264-1271.
11.	Lowe NJ, Glaser DA, Eadie N, et al. Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: A 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol, 2007, 56(4): 604-611.
12.	涂遠榮. 手汗癥現代微創治療. 福建省科學技術出版社, 2007.Tu YR. Current minimally invasive surgery of palmar hyperhidrosis. Fujian Science & Technology Publishing House, 2007.
13.	涂遠榮, 李旭, 林敏, 等. 電視胸腔鏡胸交感神經干切斷術治療手汗癥588例療效分析. 中華外科雜志, 2007, 45(22): 1527-1529.Tu YR, Li X, Lin M, et al. Video-assisted thoracoscopic sympathicotomy for the treatment of palmar hyperhldrosis in 588 cases. Chin J Surg, 2007, 45(22): 1527-1529.
14.	涂遠榮, 姚志雄, 李旭, 等. 喉罩麻醉和胸膜活檢鏡在手汗癥手術中的應用. 中華胸心血管外科雜志, 2009, 25(3): 203-204.Tu YR, Yao ZX, Li X, et al. The application of laryngeal mask anesthesia and pleural biopsy mirror in the surgery of palmar hyperhidrosis. Chin J Thorac Cardiovasc Surg, 2009, 25(3): 203-204.
15.	涂遠榮, 林敏, 陳劍鋒, 等. 胸交感神經切斷術治療原發性手汗癥2206例: 10年結果和分析. 中國微創外科雜志, 2017, 17(2): 99-103.Tu YR, Lin M, Chen JF, et al. Analysis of 10 years of outcomes among 2206 cases of endoscopic thoracic sympathotomy for primary palmar hyperhidrosis. Chin J Min Inv Surg, 2017, 17(2): 99-103.
16.	Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
17.	Young CC, Harris EM, Vacchiano C, et al. Lung-protective ventilation for the surgical patient: International expert panel-based consensus recommendations. Br J Anaesth, 2019, 123(6): 898-913.
18.	Adar R, Kurchin A, Zweig A, et al. Palmar hyperhidrosis and its surgical treatment: A report of 100 cases. Ann Surg, 1977, 186(1): 34-41.
19.	林敏, 涂遠榮, 賴繁彩, 等. 經腋窩隱痕單切口胸腔鏡下胸交感神經切斷術治療手汗癥. 中華醫學雜志, 2013, 93(41): 3300-3301.Lin M, Tu YR, Lai FC, et al. Transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis: A novel surgical approach. Natl Med J China, 2013, 93(41): 3300-3301.
20.	涂遠榮, 賴繁彩, 李旭, 等. 胸腔鏡經乳暈單切口胸交感神經切斷術治療手汗癥. 中華醫學雜志, 2011, 91(44): 3131-3133.Tu YR, Lai FC, Li X, et al. Trans-areola single port endoscopic thoracic sympathectomy for the treatment of palmar hyperhidrosis: A new surgical approach. Natl Med J China, 2011, 91(44): 3131-3133.
21.	Zhu LH, Du Q, Chen L, et al. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: Outcomes and consequences. J Thorac Cardiovasc Surg, 2014, 147(1): 25-28.
22.	Yang Y, Zeng L, An Z, et al. Minimally invasive thoracic sympathectomy for palmar hyperhidrosis via a single unilateral incision approach by the pleura videoscope. J Laparoendosc Adv Surg Tech A, 2014, 24(5): 328-332.
23.	陳安平, 宋永祥, 徐剛, 等. 劍突下單孔胸腔鏡雙側交感神經鏈切斷術治療手汗癥15例治療體會. 遵義醫學院學報, 2015, 38(5): 509-511.Chen AP, Song YX, Xu G, et al. Treatment of xiphoid single-hole bilateral thoracoscopic sympathectomy forpalmar hyperhidrosis of 15 cases. J Zunyi Med Univ, 2015, 38(5): 509-511.
24.	Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
25.	Li X, Tu YR, Lin M, et al. Endoscopic thoracic sympathectomy for palmar hyperhidrosis: A randomized control trial comparing T3 and T2-4 ablation. Ann Thorac Surg, 2008, 85(5): 1747-1751.
26.	安燚, 王振軍. 日間手術的概念和基本問題. 中國實用外科雜志, 2007, 27(1): 38-40.An Y, Wang ZJ. The concept and basic issues of day surgery. Chin J Pract Surg, 2007, 27(1): 38-40.
27.	Roberts L. Day surgery—National and international: From the past to the future. J Am Surg, 2006, 12(3): 143-145.
28.	Hodgson JA, Cyr KL, Sweitzer B. Patient selection in ambulatory surgery. Best Pract Res Clin Anaesthesiol, 2023, 37(3): 357-372.
29.	Li X, Liu Y, Zhou Y, et al. Day surgery unit robotics thoracic surgery: Feasibility and management. J Cancer Res Clin Oncol, 2023, 149(10): 7831-7836.
30.	涂遠榮, 杜泉, 陳劍鋒, 等. 胸腔鏡下擴大胸交感神經切斷術治療極重度代償性多汗一例. 中國胸心血管外科臨床雜志, 2024, 31(7): 1071-1073.Tu YR, Du Q, Chen JF, et al. Endoscopic expanded sympathotomy for the treatment of extremely severe compensatory hyperhidrosis: A case report. Chin J Clin Thorac Cardiovasc Surg, 2024, 31(7): 1071-1073.
31.	Gebitekin C, Melek H, Cetinkaya G, et al. Intercostal nerve reconstruction for severe compensatory hyperhidrosis: The Gebitekin technique. Ann Thorac Surg, 2021, 111(6): e443-e446.

1. 蔡林生, 余揚, 寧顯谷, 等. 日間手術模式下胸腔鏡胸交感神經切斷術治療手汗癥的安全性和可行性. 中國胸心血管外科臨床雜志, 2023, 30(2): 280-285.Cai LS, Yu Y, Ning XG, et al. Safety and feasibility of thoracic sympathectomy in the treatment of primary palmar hyperhidrosis based on ambulatory surgery. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(2): 280-285.
2. 曹守強, 董慶, 韓敬泉, 等. 日間手術治療手汗癥的病例對照研究. 中國胸心血管外科臨床雜志, 2016, 23(6): 537-541.Cao SQ, Dong Q, Han JQ, et al. Day surgery for palmar hyperhidrosis: A case control study. Chin J Clin Thorac Cardiovasc Surg, 2016, 23(6): 537-541.
3. 賀海奇, 趙恒, 馬磊, 等. 基于加速康復外科理念手汗癥日間手術安全性與可行性的回顧性隊列研究. 中國胸心血管外科臨床雜志, 2023, 30(11): 1556-1560.He HQ, Zhao H, Ma L, et al. The feasibility and safety of day surgery for palmar hyperhidrosis based on the principles of enhanced recovery after surgery: A retrospective cohort study. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(11): 1556-1560.
4. 李冬, 沈琦斌, 陳超. 日間喉罩全麻聯合單孔胸腔鏡交感神經切斷術治療手汗癥效果觀察. 浙江醫學, 2019, 41(10): 1059-1061.Li D, Shen QB, Chen C. Observation of the effect of day surgery on laryngeal mask anesthesia combined with single port thoracoscopic sympathectomy in the treatment of palmar hyperhidrosis. Zhejiang Med J, 2019, 41(10): 1059-1061.
5. Sang HW, Li GL, Xiong P, et al. Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: An updated systematic review. Surg Endosc, 2017, 31(11): 4357-4369.
6. Woo W, Kim BJ, Kang DY, et al. Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy. Surg Endosc, 2022, 36(11): 8340-8348.
7. Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin, 2008, 18(2): 193-207.
8. 涂遠榮, 楊劼, 劉彥國. 中國手汗癥微創治療專家共識. 中華胸心血管外科雜志, 2011, 27(8): 449-451.Tu YR, Yang J, Liu YG. Expert consensus on minimally invasive treatment of palmar hyperhidrosis in China. Chin J Thorac Cardiovasc Surg, 2011, 27(8): 449-451.
9. 涂遠榮, 劉彥國. 中國手汗癥微創治療臨床指南(2021年版). 中國胸心血管外科臨床雜志, 2021, 28(10): 1133-1139.Tu YR, Liu YG. Clinical guideline for minimally invasive treatment of palmar hyperhidrosis in China (2021). Chin J Clin Thorac Cardiovasc Surg, 2021, 28(10): 1133-1139.
10. Liu Y, Weng W, Tu Y, et al. Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version). Chin Med J (Engl), 2022, 135(11): 1264-1271.
11. Lowe NJ, Glaser DA, Eadie N, et al. Botulinum toxin type A in the treatment of primary axillary hyperhidrosis: A 52-week multicenter double-blind, randomized, placebo-controlled study of efficacy and safety. J Am Acad Dermatol, 2007, 56(4): 604-611.
12. 涂遠榮. 手汗癥現代微創治療. 福建省科學技術出版社, 2007.Tu YR. Current minimally invasive surgery of palmar hyperhidrosis. Fujian Science & Technology Publishing House, 2007.
13. 涂遠榮, 李旭, 林敏, 等. 電視胸腔鏡胸交感神經干切斷術治療手汗癥588例療效分析. 中華外科雜志, 2007, 45(22): 1527-1529.Tu YR, Li X, Lin M, et al. Video-assisted thoracoscopic sympathicotomy for the treatment of palmar hyperhldrosis in 588 cases. Chin J Surg, 2007, 45(22): 1527-1529.
14. 涂遠榮, 姚志雄, 李旭, 等. 喉罩麻醉和胸膜活檢鏡在手汗癥手術中的應用. 中華胸心血管外科雜志, 2009, 25(3): 203-204.Tu YR, Yao ZX, Li X, et al. The application of laryngeal mask anesthesia and pleural biopsy mirror in the surgery of palmar hyperhidrosis. Chin J Thorac Cardiovasc Surg, 2009, 25(3): 203-204.
15. 涂遠榮, 林敏, 陳劍鋒, 等. 胸交感神經切斷術治療原發性手汗癥2206例: 10年結果和分析. 中國微創外科雜志, 2017, 17(2): 99-103.Tu YR, Lin M, Chen JF, et al. Analysis of 10 years of outcomes among 2206 cases of endoscopic thoracic sympathotomy for primary palmar hyperhidrosis. Chin J Min Inv Surg, 2017, 17(2): 99-103.
16. Chen J, Liu Y, Yang J, et al. Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China. Surgery, 2019, 166(6): 1092-1098.
17. Young CC, Harris EM, Vacchiano C, et al. Lung-protective ventilation for the surgical patient: International expert panel-based consensus recommendations. Br J Anaesth, 2019, 123(6): 898-913.
18. Adar R, Kurchin A, Zweig A, et al. Palmar hyperhidrosis and its surgical treatment: A report of 100 cases. Ann Surg, 1977, 186(1): 34-41.
19. 林敏, 涂遠榮, 賴繁彩, 等. 經腋窩隱痕單切口胸腔鏡下胸交感神經切斷術治療手汗癥. 中華醫學雜志, 2013, 93(41): 3300-3301.Lin M, Tu YR, Lai FC, et al. Transaxillary concealing single incision endoscopic thoracic sympathectomy in the treatment of palmar hyperhidrosis: A novel surgical approach. Natl Med J China, 2013, 93(41): 3300-3301.
20. 涂遠榮, 賴繁彩, 李旭, 等. 胸腔鏡經乳暈單切口胸交感神經切斷術治療手汗癥. 中華醫學雜志, 2011, 91(44): 3131-3133.Tu YR, Lai FC, Li X, et al. Trans-areola single port endoscopic thoracic sympathectomy for the treatment of palmar hyperhidrosis: A new surgical approach. Natl Med J China, 2011, 91(44): 3131-3133.
21. Zhu LH, Du Q, Chen L, et al. One-year follow-up period after transumbilical thoracic sympathectomy for hyperhidrosis: Outcomes and consequences. J Thorac Cardiovasc Surg, 2014, 147(1): 25-28.
22. Yang Y, Zeng L, An Z, et al. Minimally invasive thoracic sympathectomy for palmar hyperhidrosis via a single unilateral incision approach by the pleura videoscope. J Laparoendosc Adv Surg Tech A, 2014, 24(5): 328-332.
23. 陳安平, 宋永祥, 徐剛, 等. 劍突下單孔胸腔鏡雙側交感神經鏈切斷術治療手汗癥15例治療體會. 遵義醫學院學報, 2015, 38(5): 509-511.Chen AP, Song YX, Xu G, et al. Treatment of xiphoid single-hole bilateral thoracoscopic sympathectomy forpalmar hyperhidrosis of 15 cases. J Zunyi Med Univ, 2015, 38(5): 509-511.
24. Cerfolio RJ, De Campos JR, Bryant AS, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg, 2011, 91(5): 1642-1648.
25. Li X, Tu YR, Lin M, et al. Endoscopic thoracic sympathectomy for palmar hyperhidrosis: A randomized control trial comparing T3 and T2-4 ablation. Ann Thorac Surg, 2008, 85(5): 1747-1751.
26. 安燚, 王振軍. 日間手術的概念和基本問題. 中國實用外科雜志, 2007, 27(1): 38-40.An Y, Wang ZJ. The concept and basic issues of day surgery. Chin J Pract Surg, 2007, 27(1): 38-40.
27. Roberts L. Day surgery—National and international: From the past to the future. J Am Surg, 2006, 12(3): 143-145.
28. Hodgson JA, Cyr KL, Sweitzer B. Patient selection in ambulatory surgery. Best Pract Res Clin Anaesthesiol, 2023, 37(3): 357-372.
29. Li X, Liu Y, Zhou Y, et al. Day surgery unit robotics thoracic surgery: Feasibility and management. J Cancer Res Clin Oncol, 2023, 149(10): 7831-7836.
30. 涂遠榮, 杜泉, 陳劍鋒, 等. 胸腔鏡下擴大胸交感神經切斷術治療極重度代償性多汗一例. 中國胸心血管外科臨床雜志, 2024, 31(7): 1071-1073.Tu YR, Du Q, Chen JF, et al. Endoscopic expanded sympathotomy for the treatment of extremely severe compensatory hyperhidrosis: A case report. Chin J Clin Thorac Cardiovasc Surg, 2024, 31(7): 1071-1073.
31. Gebitekin C, Melek H, Cetinkaya G, et al. Intercostal nerve reconstruction for severe compensatory hyperhidrosis: The Gebitekin technique. Ann Thorac Surg, 2021, 111(6): e443-e446.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content