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Endoscopic thoracic sympathectomy: at what level should you perform surgery?
Benny Weksler1, James D Luketich, Manisha R Shende
1Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite C-800, Pittsburgh, PA 15213, USA.
Thoracic Surgery Clinics
|June 19, 2008
Summary
This study proposes a clear nomenclature for sympathetic chain interventions. It recommends specific ganglion targets for treating facial, palmar, and axillary hyperhidrosis.
Area of Science:
- Neurosurgery
- Surgical Anatomy
Background:
- Sympathetic chain interventions are used for various conditions.
- Existing nomenclature for these procedures is inconsistent and confusing.
Purpose of the Study:
- To establish a uniform and precise nomenclature for sympathetic chain surgical procedures.
- To provide clear guidelines for targeting specific sympathetic ganglia for common hyperhidrosis conditions.
Main Methods:
- The authors define distinct terms for different surgical techniques: sympathectomy (resection/ablation), sympathicotomy (transaction), ramicotomy (rami severance), and sympathetic block (clipping).
Main Results:
- Proposed nomenclature includes sympathectomy, sympathicotomy, ramicotomy, and sympathetic block.
- Specific ganglion targets are recommended: T2 for facial hyperhidrosis/rubor, T3 for palmar hyperhidrosis, and T3-T4 for axillary hyperhidrosis.
Conclusions:
- A standardized nomenclature will improve clarity and consistency in surgical reporting.
- Targeted sympathetic ganglion interventions offer effective treatment for specific hyperhidrosis types.
