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Objective To study the clinical effect of endoscopic thoracic sympathectomy at different segments on palmar hyperhidrosis and research the incidence of postoperative compensatory hyperhidrosis.Methods One hundred palmar hyperhidrosis patients who underwent endoscopic thoracic sympathectomy were divided into 2 groups according to treatment method,the patients in A group (46 cases) received T4 surgery,the patients in B group (54 cases) received T3-4 surgery.The success rate of postoperative,incidence of postoperative compensatory hyperhidrosis and postoperative satisfaction rate between the 2 groups were compared.Results The surgery of 2 groups were successful.There was no statistical difference in total effective rate between the 2 groups (P ＞ 0.05).The incidence of postoperative compensatory hyperhidrosis in A group was significantly lower than that in B group [4.3％ (2/46) vs.20.4％ (11/54)],the postoperative satisfaction rate was significantly higher than that in B group [93.5％(43/46) vs.79.6％ (43/54)],there were statistical differences (P ＜ 0.05).Conclusion Endoscopic thoracic sympathectomy T3-4 or T4 surgery is very effective and safe treatment of palmar hyperhidrosis,but T4 surgery has a lower incidence of postoperative compensatory hyperhidrosis.
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Objective To explore the feasibility and application value of saving the left colic artery (LCA) feasibility in laparoscopic anterior resection of rectal carcinoma (Dixon).Methods Collecting the clinical data of 63 patients diagnosed by rectal cancer and underwent laparoscopic anterior resection of rectal carcinoma from January 2009 to June 2012,including 32 cases underwent saving LCA (saving LCA group) and 31 cases not saving LCA (no saving LCA group).The amount of bleeding volume,operation time,the number of lymph node dissection of inferior mesenteric artery in the operation,pass wind time,anastomotic ischemia,anastomotic leakage,and recurrence and metastasis were compared.Results No significant difference was found in the bleeding volume [(62.82 ± 19.72) ml vs.(60.68 ± 21.39) ml],operation time [(129.48 ± 13.69) min vs.(129.45 ± 19.78) min],the number of lymph node dissection of inferior mesenteric artery in the operation (2.93 ± 1.54 vs.3.21 ± 1.30) between two groups (P ＞0.05).No significant difference was found in pass wind time [(2.82 ± 1.16) d vs.(3.14 ± 0.92) d] after operation (P ＞ 0.05).The saving LCA group was not performed freeing colon splenic area and the terminal ileum stoma,the proximal intestinal blood circulation disorder and anastomotic leakage were not found.In no saving LCA group,4 cases were underwent ileostomy because of the proximal intestinal blood circulation disorder,2 cases occurred anastomotic leakage.During the follow-up of 2-24 months,1 case had a recurrence,3 cases had metastasis in saving LCA group.1 case had a recurrence,4 cases had metastasis in no saving LCA group.Conclusion Saving LCA in Dixon operation can ensure the anastomotic part with adequate blood supply,and reduce the occurrence of anastomotic leakage.