Endoscopic thoracic sympathectomy

ʻO ka endoscopic thoracic sympathectomy (ETS) kahi ʻoki e mālama ai i ka sweating ʻoi aku ke kaumaha ma mua o ka maʻamau. Kapa ʻia kēia ʻano he hyperhidrosis. Hoʻohana ʻia ke ʻoki e mālama ai i ka hou ʻana i ka palima a me ka helehelena. Hoʻopili ke aʻalolo sympathetic i ka hou. ʻO ke kīʻoki keʻoki i kēia mau aʻalolo i ka ʻāpana o ke kino e hou ka nui.

E loaʻa iā ʻoe ka anesthesia laulaha ma mua o ke kahakaha ʻana. ʻO kēia ka mea e hiamoe ai ʻoe a ʻaʻohe ʻeha.

Hana ʻia ke ʻano ʻoki ma ke ala aʻe:

• Hana ke kaukoki i ʻelua a ʻekolu paha ʻokiʻoki (ʻokiʻoki) ma lalo o hoʻokahi lima ma ka ʻaoʻao kahi e loaʻa ai ka sweating nui.
• Hoʻopili ʻia kou māmā ma kēia ʻaoʻao (hiolo) i ʻole e neʻe ka ea i waho a i waho i ka wā o ke ʻoki. Hāʻawi kēia i ke kaukipō i kahi lumi hou e hana ai.
• Hoʻokomo ʻia kahi kāmele liʻiliʻi i kapa ʻia he endoscope ma o kekahi o nā ʻoki i loko o kou umauma. Hōʻike ke wikiō mai ka pahu paʻi kiʻi ma kahi monitor ma ka lumi hana. ʻIke ke kauka lāʻau i ka mea nānā i ka wā o ke ʻoki ʻana.
• Hoʻokomo ʻia nā mea hana ʻē aʻe ma o nā ʻoki ʻē aʻe.
• Ke hoʻohana nei i kēia mau mea hana, loaʻa i ke kauka lāʻau nā aʻalolo e kāohi ana i ka hou ʻana i ka wahi pilikia. ʻOkiʻoki, ʻoki ʻia, a hoʻopau ʻia paha kēia mau mea.
• Hoʻonui ʻia kou māmā ma kēia ʻaoʻao.
• Hoʻopili ʻia nā ʻoki me nā humuhumu (sutures).
• E waiho ʻia paha kahi paipu hoʻowai wai i loko o kou umauma no hoʻokahi lā a ʻoi.

Ma hope o ka hana ʻana i kēia kaʻina hana ma kekahi ʻaoʻao o kou kino, e hana like paha ka mea ʻokiʻoki ma ka ʻaoʻao ʻē aʻe. Hana ke ʻoki ma kahi o 1 a 3 mau hola.

Hana pinepine ʻia kēia ʻoki ʻana i ka poʻe nona ka nui o ka palima i ʻoi aku ka nui ma mua o ka maʻamau. Hiki ke hoʻohana ʻia no ka mālama ʻana i ka hou nui o ka maka. Hoʻohana wale ʻia ia inā ʻaʻole hana nā hana ʻē aʻe e hōʻemi i ka sweating.

Nā pilikia o ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena āpau i nā lāʻau
• Nā pilikia hanu
• Kahe ʻana o ke kahe, ke koko koko, a i ʻole ka maʻi

ʻO nā pilikia no kēia kaʻina hana:

• ʻO ka hōʻiliʻili koko i ka umauma (hemothorax)
• ʻOhi ea i ka umauma (pneumothorax)
• Hoʻopilikia i nā aʻa a i ʻole nā ​​ʻalolo
• ʻO Horner Syndrome (hoʻoliʻiliʻi i ka hou o ka helehelena a me nā lihilihi maka)
• Hoʻonui a hou ʻia ka hou
• Hoʻonui ka sweating i nā wahi ʻē aʻe o ke kino (sweating compensatory)
• Hoʻolohi i ka puʻuwai puʻuwai
• Pulumonia

E haʻi i kāu kaukipoki a i ʻole mea mālama ola:

• Inā ʻoe a hāpai paha
• He aha nā lāʻau, nā wikamina, nā mea kanu, a me nā mea hoʻopili ʻē aʻe āu e lawe nei, ʻo nā mea āu i kūʻai ai me ka ʻole o ka lāʻau

I nā lā ma mua o ke kaha ʻana:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau ʻoi aku ke koko. ʻO kekahi o kēia mau aspirin, ibuprofen (Advil, Motrin), a me warfarin (Coumadin).
• E noi i kāu kaukipona i nā lāʻau e pono ai ʻoe e lawe i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu mea nāna e hāʻawi i ke kōkua no ka haʻalele. Hoʻonui ka puhi paka ʻana i ka pilikia no nā pilikia e like me ka hoʻōla lohi.

I ka lā o kou ʻoki kino:

• E hāhai i nā ʻōkuhi e pili ana i ka wā e hōʻoki ai i ka ʻai a me ka inu ʻana.
• E lawe i nā lāʻau a kāu kauka lāʻau i kauoha ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hōʻea i ka haukapila i ka manawa.

Noho ka hapa nui o ka poʻe i ka haukapila i hoʻokahi pō a hoʻi i ka home i kekahi lā aʻe. E ʻeha paha ʻoe ma kahi o hoʻokahi pule a ʻelua paha. E lawe i nā lāʻau ʻeha e like me ka ʻōlelo a kāu kauka. Hiki paha iā ʻoe ke acetaminophen (Tylenol) a i ʻole lāʻau lāʻau ʻeha. Mai kalaiwa inā ʻoe e lawe i ka lāʻau narcotic pain.

E hāhai i nā ʻōkuhi a ke kauka e pili ana i ka mālama ʻana i nā ʻokiʻoki, e like me:

• E hoʻomaʻemaʻe, maloʻo, a uhi ʻia i nā wahi ʻokiʻoki (bandages). Inā uhi ʻia kāu ʻokiʻoki me Dermabond (bandage wai) ʻaʻole ʻoe e pono i nā kāʻei.
• E holoi i nā wahi a hoʻololi i nā lole e like me ke kuhikuhi.
• E noi i kāu kaukipoki ke hiki iā ʻoe ke ʻauʻau a ʻauʻau paha.

E hoʻomau mālie i kāu mau hana maʻamau i hiki iā ʻoe.

E mālama mau i nā kipa ʻana me ke kauka. I kēia mau kipa ʻana, e nānā ke kaukōkō i nā ʻoki a ʻike inā ua kūleʻa ke ʻoki.

Hiki i kēia ʻoki ke hoʻomaikaʻi i ka maikaʻi o ke ola no ka hapanui o ka poʻe. ʻAʻole maikaʻi ia no nā poʻe i kaumaha nui ka sweating armpit. ʻIke kekahi poʻe i ka hou ʻana i ka hou me ka hou ʻana i ka hou i nā wahi hou o ke kino, akā e hele wale paha kēia.

Sympathectomy - endoscopic thoracic; ETC; Hyperhidrosis - sympathectomy endoscopic thoracic

• Mālama ʻeha ʻeha - wehe

Pūnaewele Pūnaewele Hyperhidrosis International. Sympathectomy thoracic endoscopic. www.sweathelp.org/hyperhidrosis-treatments/ets-surgery.html. Loaʻa iā ʻApelila 3, 2019.

Langtry JAA. Hyperhidrosis. I: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Ka mālama ʻana i ka maʻi ʻili: nā ʻōnaehana Therapyutic Comprehensive. 5th lā. Piladelapia, PA: Elsevier; 2018: chap 109.

Miller DL, Miller MM. Lapaʻau lapaʻau o hyperhidrosis. I: Sellke FW, del Nido PJ, Swanson SJ, eds. ʻO Sabiston lāua ʻo Spencer Surgery o ka umauma. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 44.