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Endoscopic thoracic sympathicotomy in Japan
1Kanazawa National Hospital, Cardiovascular Surgery, Japan. t14ueyam@sage.ocn.ne.jp
Annales Chirurgiae Et Gynaecologiae
|November 7, 2001
Summary
Endoscopic thoracic sympathicotomy (ETS) is a safe and effective surgical treatment for hyperhidrosis, with a low complication rate. While compensatory sweating is common, most patients manage it well, and ETS yields excellent results for hand and facial sweating.
Area of Science:
- Thoracic Surgery
- Symptomatic Treatment
- Medical Device Technology
Background:
- Hyperhidrosis and vascular disorders of the upper extremities significantly impact quality of life.
- Endoscopic thoracic sympathicotomy (ETS) has emerged as a potential treatment option.
Purpose of the Study:
- To evaluate the safety and efficacy of endoscopic thoracic sympathicotomy (ETS) for treating hyperhidrosis and upper extremity vascular disorders.
- To assess the incidence of complications and long-term outcomes associated with ETS.
Main Methods:
- A retrospective analysis of 7,017 ETS procedures performed between December 1992 and December 2000 across 50 institutions.
- Data collected via member questionnaires regarding patient activities and outcomes post-ETS.
Main Results:
- No deaths were reported related to ETS. Intraoperative bleeding occurred in 0.3% of cases, requiring reoperation in 0.08%. Permanent Horner's syndrome was observed in 0.28% of patients.
- Compensatory sweating was the most frequent side effect, with 1.2% experiencing severe symptoms requiring prolonged medical consultation.
- Excellent outcomes for hand and facial sweating were reported, with many physicians favoring ETS as a primary treatment for upper extremity vascular issues.
Conclusions:
- Endoscopic thoracic sympathicotomy (ETS) demonstrates a favorable safety profile with minimal mortality and low rates of severe complications.
- ETS is highly effective for treating palmar and facial hyperhidrosis, and is increasingly preferred for vascular disorders of the upper extremities.
- While compensatory sweating is a common sequela, its management is generally effective, allowing most patients to maintain daily activities with minimal restrictions.