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Long-term pulmonary function after thoracic sympathectomy.

Miguel A Ponce González¹, Gabriel Julià Serdà, Norberto Santana Rodríguez

¹Department of Pulmonary Medicine, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain. migp@arrakis.es

The Journal of Thoracic and Cardiovascular Surgery

|June 9, 2005

Summary

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Thoracic sympathectomy mildly impairs bronchomotor tone, affecting pulmonary function long-term. However, these changes in lung function after surgery for hyperhidrosis were not clinically significant.

Area of Science:

Pulmonary Medicine
Thoracic Surgery
Autonomic Nervous System

Background:

Thoracic sympathectomy is a surgical procedure primarily used to treat hyperhidrosis (excessive sweating).
The sympathetic nervous system plays a role in regulating various bodily functions, including potentially bronchomotor tone.
Understanding the impact of thoracic sympathectomy on pulmonary function is crucial for patient management.

Purpose of the Study:

To evaluate the midterm and long-term effects of thoracic sympathectomy on pulmonary function.
To assess the influence of the sympathetic nervous system on bronchomotor tone.

Main Methods:

Thirty-seven patients with primary hyperhidrosis undergoing thoracic sympathectomy were studied.
Pulmonary function was assessed using spirometry and methacholine challenge testing before surgery, 3 months after, and 1 year after.

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Long-term effects were evaluated through spirometry at the 1-year follow-up.

Main Results:

Spirometry 3 months post-surgery revealed significant decreases in forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and forced expiratory flow (FEF25-75%).
Methacholine challenge testing showed a non-significant increase in positive responses post-surgery.
After 12 months, FVC showed recovery, but FEV1 and FEF25-75% remained significantly reduced, though patients were asymptomatic.

Conclusions:

Thoracic sympathectomy leads to a mild but significant impairment of bronchomotor tone.
Despite pulmonary function changes, the effects of thoracic sympathectomy on bronchomotor tone appear to have no clinical consequences for patients.
These findings suggest a role for the sympathetic nervous system in regulating pulmonary bronchomotor tone.