Clinical experience in 397 consecutive thoracoscopic sympathectomies

Area of Science:

• Thoracic surgery
• Minimally invasive procedures
• Surgical treatment of autonomic disorders

Background:

• Hyperhidrosis, blushing, reflex sympathetic dystrophy, and digital ischemia are conditions that can significantly impact quality of life.
• Thoracoscopic sympathectomy offers a minimally invasive surgical approach for managing these conditions.

Purpose of the Study:

• To evaluate the safety and efficacy of thoracoscopic sympathectomy.
• To assess outcomes for patients undergoing this procedure for various indications.

Main Methods:

• Retrospective review of 202 patients who underwent thoracoscopic sympathectomy between March 1992 and April 2003.
• Analysis of 397 procedures, including synchronous bilateral sympathectomies and single-incision techniques.

Main Results:

• Symptom resolution or significant improvement in over 90% of patients.
• No mortality observed; low complication rates including pneumothorax and chylothorax.
• Compensatory sweating occurred in approximately one third of patients, but significant complaints were rare.

Conclusions:

• Thoracoscopic sympathectomy is a safe procedure with excellent results for indicated conditions.
• Compensatory sweating is the primary side effect, with significant issues being uncommon.
• Horner's syndrome is an extremely rare complication of this procedure.