Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SYMPATHECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1992

The effects of lumbar sympathectomy on regional spinal cord blood flow in rats during acute hemorrhagic hypotension.

It has not previously been determined whether the sympathetic nervous system has a role in the regulation of regional blood flow in the spinal cord. The authors used 14C-butanol distribution to measure regional spinal cord blood flow at seven cord levels, in the sciatic nerve, and in the biceps femoris muscle in 36 rats, 18 of which had undergone excision of both lumbar sympathetic chains at least 6 days previously. Blood flows were measured during pentobarbital anesthesia. Mean arterial blood pressure (MABP) was monitored and arterial pO2, pCO2, and pH were determined prior to flow measurement. Anesthetic dose and duration were controlled. Measurements were made in normotensive rats and in rats with MABP maintained at either 69 +/- 3 mm Hg or 48 +/- 3 mm Hg for 1 hour by the withdrawal of arterial blood. One-half of the rats in each group had undergone sympathectomy. The resting cord blood flow was lower than control values following sympathectomy only at the S1-4 cord level (p less than 0.01) and cauda equina (p less than 0.01), and was marginally lower at the L1-2 and L3-6 levels (p less than 0.1). Cord blood flow was unaffected by sympathectomy during moderate hypotension. During severe hypotension, cord blood flow was less than control at the C3-5 level (p less than 0.05), but did not differ from control at the other six levels. Flows in nerve and muscle were consistent with known effects of sympathectomy on peripheral tissues. It is concluded that, at most, sympathectomy may moderately decrease resting blood flow in the cord levels caudal to L-1. Sympathectomy has no major effect on regional spinal cord blood flow in rats stressed by either moderate or severe arterial hemorrhage.

Animals↗
PubMed1999

[Video-assisted thoracosopic sympathectomy: spectrum of indications and our own results (1995-1997)].

INTRODUCTION: Video-assisted thoracoscopic (VATS) sympathectomy is the most frequently used technique for surgical sympathectomy of the upper limbs. It has proven to be particularly effective in hyperhidrosis of the hands. The aim of this study is to review and discuss possible indications and analyse our own results from 1995 to 1997, including technical details on the use of a new 2-mm thoracoscope and instrumentation. PATIENTS AND METHODS: Data of all 14 consecutive patients were prospectively assessed (8 females, 6 males, mean age 44 years; range 22-74 years). A total of 26 thoracoscopic sympathectomies were performed. Indications included: 7 cases of hyperhidrosis, 4 of inoperable and medically intractable angina pectoris, 3 of vascular diseases of the upper extremity. All patients were reexamined 3 months postoperatively and late follow-up was obtained in all patients, with a mean follow-up of 20 months postoperatively (4-36 months) by questionnaire. RESULTS: 22 Th2-Th5 and 4 Th2-Th4 resections of the sympathetic chain were performed. There was no conversion to open surgery. The mean operating time was 67 minutes (range 50-90 min.). One (3.8%) unilateral Horner syndrome occurred with complete recovery during follow up. Compensatory sweating occurred in 7 (50%). The mean hospitalisation was 4.7 days for all patients and 2.8 days for those with hyperhidrosis. In 10 patients (71.5%), symptoms of the underlying disease had completely ceased on the day of discharge, and in 4 (28.5%) the symptoms had improved. Two months postoperatively a unilateral relapse occurred in one patient with Raynaud's disease. After a mean of 20 months, the quality of life was improved in 12 (85%) and was unchanged as compared to preoperatively in 2 (15%). CONCLUSIONS: Primary hyperhidrosis showed the best results after thoracoscopic sympathectomy. Although experience with angina pectoris is still limited, thoracoscopic sympathectomy seems to be a valuable alternative in otherwise inoperable cases. In upper-extremity vascular diseases the operation can be performed as a last therapeutic option, but relapse often occurs in these patients. 2-mm instrumentation decreases trauma and postoperative pain and improves cosmetic results, which obviously may play a role in younger patients with hyperhidrosis. Patients should be warned about compensatory sweating before thoracic sympathectomy.

Adult↗
PubMed2000

Video-assisted transthoracic sympathectomy in the treatment of primary hyperhidrosis: friend or foe?

The authors hypothesize that palmar hyperhidrosis is a systemic manifestation of abnormal sudomotor function; consequently, thoracoscopic sympathectomy to alleviate symptoms in the hands may result in heat dissipation because sweating is transferred to other sites. To investigate this phenomenon and to determine whether it adversely affects patient satisfaction, a standard questionnaire was administered to 626 patients who underwent sympathectomy at a university-associated public hospital between 1991 and 1998; only patients treated at least 6 months before questionnaire distribution were included in the study. Replies were received from 336 (53.7%) individuals. The surveyed patients underwent bilateral T2, T3 (palmar sweating), or T3, T4 (axillary sweating) sympathectomy by a standard video-assisted transthoracic technique. Main outcome measures included the incidence of dry hands, compensatory sweating, chest pain, upper-limb muscle weakness, shortness of breath, and gustatory phenomena; in addition, patient perception of the success of the surgical procedure was assessed. After sympathectomy, 97.3% (P < 0.0001) and 29.2% (P < 0.001) of patients reported significant improvement in palmar hyperhidrosis and axillary sweating, respectively. Postsurgery, severe compensatory sweating was experienced in 90% of patients (P < 0.0001). The sites of compensatory sweating were the back (75%), abdomen (51%), feet (23%), groin and thigh (13%), chest (13%), and axillae (8%). Transient whole-body sweating for no apparent reason was experienced in 30% of patients. Thirty-seven patients (11%) regretted having undergone the surgical procedure. In contrast, 25% and 64% of patients were either satisfied or very satisfied with the outcome of the procedure. From the survey results, the authors conclude that palmar hyperhidrosis is a systemic manifestation of abnormal sudomotor function and that thoracic sympathectomy may alleviate symptoms in a large proportion of patients. However, for some individuals, compensatory sweating may prove to be an equally troublesome handicap. Because the occurrence of severe compensatory sweating is unpredictable, a reversible sympathectomy may be desirable.

Adolescent↗
PubMed2002

Uniportal endoscopic thoracic sympathectomy for treatment of palmar and axillary hyperhidrosis: analysis of 2000 cases.

OBJECTIVE: Primary hyperhidrosis of the upper limbs is a common and troublesome condition in Taiwan. Therefore, we present our experience in treating hyperhidrosis via uniportal endoscopic thoracic sympathectomy. METHODS: Between April 1993 and March 2000, a total of 2000 patients underwent endoscopic thoracic sympathectomy for treatment of palmar or axillary hyperhidrosis. There were 1520 patients with palmar hyperhidrosis and 480 patients with axillary hyperhidrosis. There were 788 male and 1212 female patients, with a mean age of 22.9 years (range, 9-60 yr). All patients were placed in a semi-sitting position, with single-lumen-intubation anesthesia. We performed T2 sympathectomy at the second and third rib beds for patients with palmar hyperhidrosis, using an 8-mm, 0-degree, offset thoracoscope (Karl Storz GmbH & Co., Tuttlingen, Germany), via a 0.8-cm incision below each axilla. Similar procedures were used for T3 and T4 sympathectomies at the third, fourth, and fifth rib beds for patients with axillary hyperhidrosis. Questionnaires were sent to all patients after surgery. RESULTS: Among these 2000 patients, successful bilateral sympathectomies were performed for 1992 patients. The operations were usually completed within 20 minutes (range, 10-30 min). Most patients were discharged within 4 hours after surgery. The surgical complications were minimal, including pneumothorax (10 cases, 0.5%), segmental atelectasis (7 cases, 0.35%), hemothorax (2 cases, 0.1%), and mild wound infections (2 cases, 0.1%). There were no surgery-related deaths. The mean postoperative follow-up period was 51.7 months (range, 6-89 mo). A total of 1720 patients (86%) developed compensatory sweating of the trunk and lower limbs. The recurrence rates for palmar and axillary hyperhidrosis after surgery were 0 and 4.1% in the first year, 0.1 and 8.2% in the second year, 0.5 and 10.4% in the third year, 0.6 and 14.1% in the fourth year, and 1.3 and 16.7% in the fifth year, respectively. CONCLUSION: Uniportal endoscopic thoracic sympathectomy is a safe, effective method for the treatment of patients with palmar or axillary hyperhidrosis. For surgery, both a semi-sitting position and single-lumen-intubation anesthesia are recommended.

Adolescent↗
PubMed1990

[Results of therapy following lumbar sympathectomy. A retrospective study over the course of 10 years].

In a retrospective study we report about 142 patients who had 159 lumbar sympathectomies from 1975-1985. The angiological status was evaluated with a clinical examination or a questionnaire. In 96% we saw the clinical stages III and IV. The clinic lethality was 3.5%. Besides the sympathectomies 62 reconstructive procedures were necessary which were performed mostly before the sympathectomy. The higher the occlusion resp. stenosis the worse the prognosis after sympathectomy. A postoperative abstinence of smoking improves the prognosis. The amputation rate was 35.8% including minor amputations (n = 20) and loss of the extremity (n = 37). The high number of minor amputations shows that the sympathectomy is an appropriate procedure to shift the amputation to the periphery. The older the patient the higher the amputation rate. The analysis of the clinical examination or the questionnaire shows that a third of the patients has a long-term profit from the sympathectomy.

Adult↗
PubMed1985

Surgical sympathectomy of the heart in rodents and its effect on sensitivity to agonists.

A new procedure for sympathetic denervation of the hearts of rats and guinea pigs is described. Bilateral removal of the inferior and medial cervical ganglia results in almost complete loss of catecholamines from atria and ventricles, disappearance of catecholamine-associated histofluorescence from the region of the sinoatrial node and marked depression of the chronotropic concentration-response curve for tyramine in right atria of both species. Seven days after bilateral sympathectomy, the chronotropic concentration-response curve for isoproterenol is shifted to the left by a factor of 3.3 in the rat and 1.7 in guinea-pig right atria. The chronotropic concentration-response curve for histamine was not shifted by sympathectomy in the guinea-pig right atrium. Inasmuch as the rat atrium does not respond to histamine, similar experiments could not be done in the rat. The inotropic concentration-response curve for isoproterenol in electrically driven left atria was not affected by 7 days of sympathectomy in either species. These results indicate that chronic surgical sympathectomy of the heart can be successfully accomplished in the rat and guinea pig. Such sympathectomy induces a postjunctional supersensitivity in guinea-pig right atria which is qualitatively and quantitatively similar to that described previously for chronic treatment with reserpine. Bilateral surgical sympathectomy provides a valuable tool for future investigations of the cellular basis of supersensitivity in the myocardium.

Animals↗
PubMed1977

Clinical results of lumbar sympathectomy alone or as a complement of direct arterial surgery.

Six hundred and eighty patients underwent conservative surgery for chronic obliterative arterial disease of the lower limbs during a 15 year period ranging from 1960 to 1974. Two hundred and fifty-three lumbar sympathectomy were performed in 240 patients, 339 patients had direct surgery and in 133 cases lumbar sympathectomy was added to direct surgery. From this experience the authors conclude: 1. Lumbar sympathectomy has a low mortality rate (3 deaths or 1.18%) and no important after effects: in particular no sexual problems are reported. 2. Lumbar sympathectomy for intermittent claudication seems to be useful since it apparently improves symptoms and prognosis of the operated leg. 3. Lumbar sympathectomy for rest pains or necrosis can be useful in 1/3 of the patients with proximal arterial lesions and in 2/3 of the patients with only peripheral lesions. 4. Lumbar sympathectomy should always be added to direct arterial surgery above the inguinal ligament since it improves the patency rate of arterial reconstruction without increasing the operative risk.

Arterial Occlusive Diseases↗
PubMed1995

[Selective endoscopic sympathectomy for palmar hyperhidrosis].

OBJECTIVES: Thoracic sympathectomy is the radical and usually definite treatment of palmar hyperhidrosis. Improvement of surgical endoscopy techniques makes it possible to perform the procedure through thoracoscopy, thus minimizing operative trauma and sequellae. However, thoracic sympathectomies give rise to a high rate of compensatory sweating which is the most important adverse effect of the technique. METHODS: We developed a technique of selective sympathectomy which only divides the rami communicanti from the first to the fourth thoracic ganglion. We performed 90 thoracic sympathectomies in 46 patients. They were performed in a truncal manner in 32 patients while it was selective in the last 14 patients. RESULTS: The success rate was 97.5% (2 failures). After reoperation of these 2 failures, the success rate was 100%. The global rate of compensatory sweating was 47.5%. In the 14 last patients who underwent a selective sympathectomy, only one complained of compensatory sweating. CONCLUSION: Endoscopic sympathectomy is an effective means of treating palmar hyperhidrosis. Rigorous technique should help reduce the risk of compensatory sweating.

Adult↗
PubMed1996

Minimally invasive surgery: video endoscopic thoracic sympathectomy for palmar hyperhidrosis.

Palmar hyperhidrosis (PH) is a common disorder in Taiwan. It often causes social embarrassment and occupational handicaps. So far, there has been no satisfactory treatment for PH. In 1990, we first developed a minimally invasive technique: video endoscopic sympathectomy to treat PH. The procedure has subsequently proven to be a standard treatment for PH. In this study, a survey of 9988 cases of PH patients from 17 hospitals in Taiwan treated by this method during the past 5 years is presented. Although there were some variations in the model of anaesthesia, technique and extent of sympathectomy, the postoperative results were generally satisfactory. Both sides of sympathectomy were mostly accomplished within half an hour in one stage. The operative scars were tiny and concealed in the axillary region. The patients were discharged from the hospital after an overnight stay. Complications such as pneumothorax, haemothorax (0.3%) or Horner's syndrome (0.1%) were rare. There was no surgical mortality in this series. The most common complication was compensatory hyperhidrosis which was usually mild to moderate and tolerable after reassurance. The recurrence rate of PH was approximately 1% in the first year and less than 3% during the 3 years of follow up. Intraoperative monitoring of palmar skin temperature (PST) was advocated to confirm an adequate sympathectomy warranting a definite result. En bloc ablation of T2 segment invariably resulted in a rise of PST to about 2 degrees C and was considered as an adequate extent of sympathectomy for PH. The refined technique was extended to treat young children with PH and patients with craniofacial hyperhidrosis. The therapeutic results were generally excellent with minimal morbidity and rare recurrence. It is concluded that video endoscopic en bloc T2 sympathectomy is a simple, minimally invasive and effective treatment for both adults and children with PH and also for patients with craniofacial hyperhidrosis.

Adolescent↗
PubMed2000

Are we paying a high price for surgical sympathectomy? A systematic literature review of late complications.

The purpose of this article was to systematically review the literature in order to assess (1) the current indications for surgical sympathectomy and (2) the incidence of late complications collectively and per indication. All types of upper or lower limb surgical sympathectomies are included. An extensive search strategy looked for controlled trials and observational studies or case series with an english abstract. Out of 1,024 abstracts from MEDLINE and 221 from EMBASE, 135 articles reporting on 22,458 patients and 42,061 procedures (up to april 1998) fulfilled the inclusion criteria. Weighted means were used to control for heterogeneity of data. No controlled trials were found. The main indication was primary hyperhidrosis in 84.3% of the patients. Compensatory hyperhidrosis occurred in 52.3%, gustatory sweating in 32.3%, phantom sweating in 38.6%, and horner's syndrome in 2.4% of patients, respectively, with cervicodorsal sympathectomy, more often after open approach. Neuropathic complications (after cervicodorsal and lumbar sympathectomy) occurred in 11.9% of all patients. Compensatory hyperhidrosis occurred 3 times more often if the indication was palmar hyperhidrosis instead of neuropathic pain (52.3% versus 18.2%), whereas neuropathic complications occurred 3 times more often if the treatment was for neuropathic pain instead of palmar hyperhidrosis (25.2% versus 9.8%). Surgical sympathectomy, irrespective of approach, is accompanied by several potentially disabling complications. Detailed informed consent is recommended when surgical sympathectomy is contemplated.

Journal Article↗
PubMed2001

The effect of lumbar sympathectomy in the spinal nerve ligation model of neuropathic pain.

To evaluate the sympathetic dependency of pain behaviors in an animal model of neuropathic pain, the effect of surgical sympathectomy on the mechanical sensitivity of the hindpaw was examined in rats with L5 spinal nerve ligation. Mechanical sensitivity was determined by measuring foot withdrawal thresholds to mechanical stimulation with von Frey filaments applied to the base of the third or fourth toe. Tight ligation of the segmental L5 spinal nerve led to the development of mechanical hypersensitivity in the hindpaw. The effects of 2 different procedures of surgical lumbar sympathectomy on mechanical hypersensitivity were compared, limited (resection of sympathetic chain/ganglia L2 to L4 segments) and extensive (resection of L2 to L6 segments) sympathectomies. Mechanical hypersensitivity produced by L5 spinal nerve ligation was partially but significantly reduced by both sympathectomy procedures. In a separate group of rats, the L5 spinal nerve was ligated while irritating the neighboring L4 spinal nerve. This procedure produced a lesser degree of mechanical hypersensitivity, and subsequent sympathectomy had no effect on these animals. These data suggest that sympathectomy is effective in this model only when the animals show severe mechanical hypersensitivity.

Journal Article↗
PubMed1997

Intrathecal sufentanil for labor analgesia does not cause a sympathectomy.

BACKGROUND: Intrathecal sufentanil (ITS) is frequently used to provide analgesia during labor. Decreases in blood pressure and sensory changes in this circumstance suggest that ITS may have a local anesthetic effect and thus cause a sympathectomy. To determine whether ITS given to laboring women causes a sympathectomy, the authors evaluated central and lower extremity temperature changes after ITS administration. These findings were compared with those in a control group of women having spinal anesthesia with bupivacaine for elective cesarean section in whom an extensive sympathectomy was expected. METHODS: Twenty parturients classified as American Society of Anesthesiologists' physical status 1 or 2 had temperatures measured centrally, at the calf, and at the great toe at frequent intervals after receiving 10 microg ITS for labor analgesia (sufentanil group, n = 10), or hyperbaric bupivacaine 12 mg in their spinal anesthetic for cesarean section (bupivacaine group, n = 10). Calf-to-toe temperature indices (C-T) were calculated by subtracting toe temperature from calf temperature. A decrease in this index means that the toe had warmed compared with the calf and is an indication of vasodilation and a sympathectomy. RESULTS: There was no significant change in the C-T indices or central temperature in the sufentanil group, but the C-T indices and central temperature decreased significantly in the bupivacaine group. CONCLUSIONS: The decreases in the C-T index and central temperature in the bupivacaine group indicate the presence of a sympathectomy. The lack of change in the C-T indices and central temperature in the sufentanil group indicates that no significant vasodilation occurred. Therefore, the decrease in blood pressure seen after ITS administration for labor analgesia is unlikely to be the result of a sympathectomy.

Adult↗
PubMed1984

The effect of chemical and surgical sympathectomy on gastric secretion and innervation.

The purpose of this project was to evaluate the effects of chemical and surgical sympathectomy on gastric acid secretion (GAS) and mucosal innervation in the dog. Chemical sympathectomy was achieved with 6-OHDA and surgical sympathectomy was performed by excising the celiac and superior mesenteric ganglia. Gastric biopsies for fluorescence microscopy were taken before and after sympathectomy, as was pentagastrin (PPG) stimulated GAS. Each sympathectomy increased GAS in response to submaximal doses of PPG while simultaneously destroying adrenergic nerve terminals in the gastric mucosa. 6-OHDA caused a complete degeneration of nerve terminals at one week, but regeneration was complete by 9 weeks. The data support the concept that the sympathetic innervation of the stomach is an inhibitor of GAS.

Animals↗
PubMed2004

Video-assisted thoracic surgery sympathectomy for hyperhidrosis.

HYPOTHESIS: Video-assisted thoracic surgery sympathectomy is efficacious for patients with hyperhidrosis. DESIGN: An experience with patients undergoing bilateral video-assisted thoracic surgery sympathectomy was reviewed to evaluate the operative technique and to determine morbidity and outcomes. SETTING: Academic health center. PATIENTS: The cohort included 31 patients (22 women and 9 men). All but 2 patients were of Asian descent, and the average age was 24.9 years. All patients had palmar hyperhidrosis. Two patients also had craniofacial hyperhidrosis, and another 2 had pedal hyperhidrosis. INTERVENTIONS: Bilateral video-assisted thoracic surgery sympathectomy with resection of the second and third ganglia was performed in all patients. Small chest tubes were removed on the first postoperative day. In 30 patients, the procedures were simultaneous; and in 1, it was staged to accommodate lumbar sympathectomy for pedal disease. RESULTS: Perioperatively, no patients died. The only hospital complication was an intraoperative injury to an intercostal artery that required conversion to an open thoracotomy. The average hospital length of stay was 1.2 days (range, 1-3 days). No patient developed Horner syndrome. Long-term follow-up was 2.6 years (range, 3 months to 7 years). Both hands in all patients were warm and dry at the last follow-up, as were the face and scalp in the 2 with craniofacial hyperhidrosis. Ten patients (32%) experienced compensatory sweating, which improved within 6 months. CONCLUSIONS: In this experience, palmar hyperhidrosis is predominantly a disease of young Asian women. Simultaneous bilateral video-assisted thoracic surgery sympathectomy is effective and can be accomplished with minimal morbidity and a short hospitalization. Compensatory sweating occurs in a third of patients, but is generally self-limiting.

Adult↗
PubMed1977

Value of concomitant sympathectomy in aortoiliac reconstruction. Results of a prospective, randomized study.

The efficacy of concomitant lumbar sympathectomy in improving results of aortoiliac reconstruction was assessed by a prospective, randomized study of 51 patients undergoing operation for occlusive or aneurysmal disease. Sympathectomy was performed on 50 limbs, while 52 extremities served as controls. Sympathectomy resulted in a significant reduction in foot vascular resistance determined by plethysmography. However, the procedure had no effect on leg circulation, assessed by ankle/arm pressure indices determined by Doppler ultrasound. In the sympathectomy group, there were three early postoperative amputations for ischemia, despite patent grafts. In the control group, there was one late graft occlusion, caused by progressive atherosclerotic disease. Although sympathectomy may improve pedal circulation, the procedure does not appear to improve the results of aortoiliac reconstruction.

Adult↗
PubMed2002

The effects of chemical sympathectomy on T-cell cytokine responses are not mediated by altered peritoneal exudate cell function or an inflammatory response.

Ablation of the sympathetic nervous system by chemical sympathectomy is a standard model for the study of sympathetic nervous system regulation of immune function. We have previously documented that chemical denervation results in enhanced antigen-specific, but suppressed mitogen-induced, cytokine production by spleen cells. In our investigation into the mechanisms of sympathectomy-induced immune alterations, we first evaluated the peritoneal environment into which the protein antigen keyhole limpet hemocyanin is administered. Denervation resulted in increased production of tumor necrosis factor-alpha by peritoneal exudate cells and these cells appeared to have enhanced antigen presenting capability. We hypothesized that nerve terminal destruction may be inducing an inflammatory response by monocyte/macrophages and other cell types throughout the periphery that could differentially alter subsequent mitogen versus antigen-specific responses. However, no evidence of sympathectomy-induced systemic or local splenic inflammatory responses was observed, as indicated by measuring the proinflammatory cytokines tumor necrosis factor-alpha and interleukin-1beta. These experiments indicate that an inflammatory response is not likely to be responsible for sympathectomy-induced immune alterations, eliminating a potential confounding factor in interpreting sympathectomy studies.

Animals↗
PubMed1996

Advantages of limited thoracoscopic sympathectomy.

BACKGROUND: Thoracoscopic resection of the first through the fourth thoracic sympathetic ganglion for palmary and axillary hyperhidrosis and Raynaud's syndrome is associated with a high initial success rate. However, the reported incidence of compensatory hyperhidrosis of the trunk and legs and Horner's syndrome are high. This study assesses the results of thoracoscopic sympathectomy limited to transection of the interganglionic trunk or resection of one or two thoracic ganglia. METHODS: Twenty-eight thoracoscopic sympathectomies were done for dystrophy of the hand (n = 9), palmar and axillary hyperhidrosis (n = 6), and Raynaud's syndrome (n = 4). The extent of sympathectomy varied from interganglionic division between the second and third ganglion (n = 12), to resection of the third ganglion (n = 12), to resection of the second and third ganglion (n = 4). RESULTS: Sympathectomy resulted initially in relief of symptoms in all cases. Horner's syndrome did not occur. CONCLUSIONS: After a median follow-up of 11 months, two of nine patients with dystrophy judged the result of operation as good. All patients with hyperhidrosis and Raynaud's syndrome judged the result of sympathectomy as good. Compensatory hyperhidrosis was experienced by two patients with dystrophy of the hand who had removal of the second and third sympathetic ganglion.

Adolescent↗
PubMed1990

A new method of thoracoscopic sympathectomy in hyperhidrosis palmaris.

Although hyperhidrosis palmaris is a benign condition, it may cause considerable psychological, social, and occupational disturbances. There are many conservative measures used to treat hyperhidrosis, but surgical sympathectomy is the only permanent cure. Of the various surgical approaches to the upper thoracic sympathetic ganglia, one must select the approach that combines good functional results and a satisfactory cosmetic outcome with only minor complications. Twenty-one patients (10 men and 11 women) with hyperhidrosis palmaris underwent synchronous bilateral T2 sympathectomy between 1 October 1989 and 30 April 1990. These patients underwent a new method of thoracoscopic sympathectomy without preoperative pneumothorax. All were relieved of excessive sweating in their upper extremities immediately after the operation. In addition, the technique led to significant savings in operation and hospitalization time. We recommend thoracoscopic sympathectomy as the best approach for sympathectomy in cases of hyperhidrosis palmaris.

Adolescent↗