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Upper thoracic sympathectomy
1Beilinson Medical Center, Petah Tikva / Sackler School of Medicine, Tel Aviv, Israel.
Surgical Technology International
|May 8, 2015
Summary
Sympathetic denervation of the upper extremity impacts blood flow and sweating. Historically used for various conditions, its current indications are limited to hyperhidrosis, causalgia, severe vasospastic disorders, and ischemic extremities.
Area of Science:
- Vascular Surgery
- Autonomic Nervous System Physiology
Background:
- Sympathetic stimulation causes vasoconstriction and sweating in extremities.
- Blocking the sympathetic system increases blood flow and skin warmth, reducing sweating.
Purpose of the Study:
- To review the historical and current indications for upper thoracic sympathectomy.
- To delineate the physiological effects of sympathetic denervation on extremity vasculature.
Main Methods:
- Literature review of historical and contemporary surgical practices.
- Analysis of physiological responses to sympathetic blockade in extremities.
Main Results:
- Upper thoracic sympathectomy was previously indicated for numerous conditions, including asthma, hypertension, and Raynaud's disease.
- Current indications are restricted to hyperhidrosis, causalgia, severe vasospastic disorders, and ischemic changes like Buerger's disease.
Conclusions:
- The therapeutic scope of upper thoracic sympathectomy has significantly narrowed over time.
- Current applications focus on specific, severe conditions affecting extremity circulation and sympathetic function.

