[Surgical indications and results of thoracic sympathectomy]

Between the 1st of July 1971 and the 31st of December 1974, among 1,459 operations on vascular surgery, we carried out 77 thoracic sympathectomies in 46 patients. In most patients there was an oblitering angiopathie of digital type, stage II to IV, confirmed by angiography. Two patients had mixed type obstructions, two others had hyperhidrosis, one patient suffered from cleroderma, another had a thoracic outlet syndrome with digital arterial obstruction. In all cases, the transaxillary approach was that which caused the least complications and which permitted satisfactory exposure of the sympathetic nerve. The cosmetic results were good. The second and third thoracic ganglia were resected and the planes of cleavage marked with silver clips. In advanced stage III and stage IV, we noted 92 p. 100 improvements i.e. return to stages I or II. The operative mortality was nil. The most serious complication was a case of hemothorax which required later pulmonary decortication. We noted in two cases, a Horner's syndrome.