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Upper thoracic sympathetic surgery. Open surgical techniques.

D Kopelman1, M Hashmonai

  • 1Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|December 16, 2003
PubMed
Summary
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Four open surgical approaches for upper thoracic sympathectomy were historically used. Success rates were similar across methods, with thoracoscopic surgery now being the preferred technique.

Area of Science:

  • Thoracic Surgery
  • Surgical Techniques

Background:

  • Upper thoracic sympathectomy has historically utilized four open surgical approaches.
  • These include posterior, anterior transthoracic, supraclavicular, and transaxillary techniques.

Purpose of the Study:

  • To review and compare the historical open surgical approaches for upper thoracic sympathectomy.
  • To discuss the evolution of surgical techniques in this field.

Main Methods:

  • Review of historical surgical approaches for upper thoracic sympathectomy.
  • Comparison of outcomes and technical considerations for each open approach.

Main Results:

  • Posterior and anterior transthoracic approaches are largely abandoned due to pain and low popularity, respectively.

Related Experiment Videos

  • Supraclavicular and transaxillary approaches were common but superseded by thoracoscopic surgery.
  • Success rates, recurrences, and sequelae were comparable across open techniques, dependent on the sympathectomy procedure itself, not the surgical access route.

    • Conclusions:

    • Open surgical approaches for upper dorsal sympathectomy are now rarely used, primarily reserved for cases where thoracoscopy is not feasible.
    • The choice of surgical technique for sympathectomy, rather than the access route, dictates patient outcomes.