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2010年12月31日 星期五

16-05-05.交感神經切除術的起源背景:

 
資料來源:瑞典手汗交感神經切除術受害者聯盟  網址:
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BACKGROUND
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Sympathectomies have been performed for many years. From the beginning it was a very large operation. The surgeon went through open surgery from the back side towards the sympathetic chain where parts of the sympathetic ganglia was removed. We believe that the operation is known since the beginning of 1900.
In 1920 a surgeon by the name of Kotzareff made the first (?) sympathectomy against hyperhidrosis. In the 1930's the american neurosurgeon Smithwick used sympathectomies as a way to treat high bloodpressure.
The results of the operation was not always as good as one had hoped for. The surgery sometimes lead to rather severe pain and, especially after Smithwicks operation, impotence.
In Sweden has, in "modern" time, this kind of thorakal sympathectomy been used as at treatment for palmar hyperhidrosis at least since the 1960's. The extensive surgery caused long-lasting pain, which lead to inability to work for up to about two months. These disadvantages probably lead to the developing of Endoscopic Thoracic Sympathectomy (ETS).
In 1978 a surgeon by the name of Kux described a surgery with a "thoracic endoscope for sympathectomy". Endoscopic Thoracic Surgery (ETS) has been performed in Sweden since about 1985. Instead of cutting the sympathetic nerve during open surgery, the operation is performed through one or two endoscopes which is inserted between the ribs into the chest. From the patients view this operation is much more "mild". Usually he/she can go back to work after at the most 7-10 days.
This kind of operation is also used to treat f.e. facial blushing and angina pectoris.
The operating hospitals claim in their marketing that ETS does not cause any serious side effects. The only side effect that is confirmed is that Horner's Syndrom can occur in a few cases, and that compensatory sweating can occur in 10 - 70% of the patients. (These figures varies between different operating hospitals). They also claim that the "CS" is very mild and tolerable.
We who have been operated and found ourselves with several severe side effects are off a different opinion. See
Side effects.
交感神經節手術的起源背景(翻譯)
據信,交感神經節手術是起始於1900年,當時是一種非常大的手術,外科醫師直接由患者背部開刀,切除部分交感神經節。
1920年,有一位叫Kotzareff的醫師,針對多汗症患者做了首例(?)交感神經節切除術。
1930年,有一位叫Smithwick的醫師,把交感神經切除術用來治療高血壓。
然而手術的效果並不好,所希望的效果並沒有達到,有的患者併發嚴重的術後疼痛,尤其是Smithwick的手術,產生了陽痿。
在瑞典,胸推交感神經切除術被用來治療多汗症,至少在1960年代開始,這種大手術常導致長時間的疼痛,無法工作的時間長達兩個月。
為了消除上述的手術副作用,內視鏡胸交感神經切除術(Endoscopic Thoracic Sympathectomy-ETS)焉是誕生。
1978年,一位叫Kux的外科醫師首創ETS1985年,瑞典才開始做ETS手術,由於ETS不必像傳統手術那樣由背部開刀,只是用內視鏡由肋骨間進入完成交感神經節切除手術,由患者觀點來看,這種手術算是較輕微了,通常只需7-10天就可以恢復工作。
ETS手術的副作用是少數人會引起荷納氏症侯群(Horner’s Syndrome)以及約有10-70%的患者。(各醫院統計不同)會引起反射性出汗,但反射性出汗通常是輕微且可以忍受的,但是事實上並非如此,事實的真相是各種嚴重的副作用層出不窮。
本段文字翻譯整理自“瑞典交感神經切除術受害者自救聯盟”。

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