Advertisement

Hyperhidrosis pp 179-188 | Cite as

Surgical Difficulties and Complications of Video-Assisted Thoracoscopic for Thoracic Sympathectomy

  • Laert de Oliveira Andrade Filho
  • Fabiano Cataldi Engel
Chapter

Abstract

This chapter discusses the most common technical difficulties during the surgical procedure of sympathectomy, as well as the most frequent surgical complications, based on the literature and experience of the group with more than 2000 operated cases. The most frequent and most compromising technical difficulty is the presence of pleural adhesions. The most frequent immediate complication is the air fistula, and the most frequent late complication is compensatory sweating.

Keywords

Sympathectomy Technical difficulties Complications Compensatory sweating Compensatory hyperhidrosis 

Suggested Reading

  1. Adar R, Kurchin A, Zweig A, Mozes M. Palmar hyperhidrosis and its surgical treatment: a report of 100 cases. Ann Surg. 1977;186:34–41.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Andrade Filho LO, Kuzniec S, Wolosker N, Yazbec G, Kauffman P, de Campos JRM. Technical difficulties and complications of symphatectomy in the treatment of hyperhidrosis: an analysis of 1731 cases. Ann Vasc Surg. 2013;27(4):447–53.CrossRefPubMedGoogle Scholar
  3. Andrews BT, Rennie JA. Predicting changes in the distribution of sweating following thoracoscopic sympathectomy. Br J Surg. 1997;84:1702–4.CrossRefPubMedGoogle Scholar
  4. Asking B, Svartholm E. Degeneration activity; a transient effect following sympathectomy for hyperhidrosis. Eur J Surg Suppl. 1994;572:41–2.Google Scholar
  5. Atherton WG, Morgan WE. False aneurysm of an intercostal artery after thoracoscopic sympathectomy. Ann R Coll Surg Engl. 1997;79:229–30.PubMedPubMedCentralGoogle Scholar
  6. Atkins HJB. Sympathectomy by the axillary approach. Lancet. 1954;1:538–9.CrossRefGoogle Scholar
  7. Cameron AEP. Complications of endoscopic sympathectomy. Eur J Surg Suppl. 1998;580:33–5.Google Scholar
  8. de Campos JRM, Kauffman P, Werebe EC, Andrade Filho LO, et al. Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg. 2003;76:886–91.CrossRefPubMedGoogle Scholar
  9. de Campos JRM, et al. The body mass index and level of resection. Predictive factors for compensatory sweating after sympathectomy. Clin Auton Res. 2005;15:116–20.CrossRefPubMedGoogle Scholar
  10. Chiou TS-M, Chen S-C. Intermediate-term results of endoscopic transaxillary T2 sympathectomy for primary palmar hyperhidrosis. Br J Surg. 1999;86:45–7.CrossRefPubMedGoogle Scholar
  11. Drott C, Claes G, Gothberg G, Paszowski P. Cardiac effects of endoscopic electrocautery of the upper thoracic sympathetic chain. Eur J Surg Suppl. 1994;572:65–70.Google Scholar
  12. Duarte JBV, Kux P. Efficacy of endoscopic thoracic sympathectomy along with severing the Kuntz nerve in the treatment of chronic non-infectious rhinitis. Ann Chir Gynaecol. 2001;90:189–92.PubMedGoogle Scholar
  13. Dumont P. Side effects and complications of surgery for hyperhidrosis. Thorac Surg Clin. 2008;18:193–207.CrossRefPubMedGoogle Scholar
  14. Dumont D, Denoyer A, Robin P. Long-term results of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg. 2004;78:1801–7.CrossRefPubMedGoogle Scholar
  15. Franz Marhold F, Izay B, Zacherl J, Tschabitscher M, Neumayer C. Thoracoscopic and anatomic landmarks of Kuntz’s nerve: implications for sympathetic surgery. Ann Thorac Surg. 2008;86:1653–8.CrossRefPubMedGoogle Scholar
  16. Gossot D, Grunenwald D, et al. Early complications of thoracic endoscopic sympathectomy: a prospective study of 940 procedures. Ann Thorac Surg. 2001;71:1116–9.CrossRefPubMedGoogle Scholar
  17. Gossot D, Galetta D, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg. 2003;75(4):1075–9.CrossRefPubMedGoogle Scholar
  18. Gossot D, Grunenwald D, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Eur J Cardiothorac Surg. 2005;27:741–4.CrossRefGoogle Scholar
  19. Herbst F, Fugger R, Fritsch A, et al. Endoscopic thoracic sympatectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations. Ann Surg. 2002;89:158–62.Google Scholar
  20. Hughes J. Endothoracic sympathectomy. Proc R Soc Med. 1942;35:585–6.PubMedPubMedCentralGoogle Scholar
  21. Kauffman P, Wolosker N, de Campos JRM, Yazbec G, Jatene FB. Azygos lobe: a difficulty in video-assisted thoracic sympathectomy. Ann Thorac Surg. 2010;89(6):57–9.CrossRefGoogle Scholar
  22. Kopleman D, Bahous H, Assalia A, Hashmonai M. Upper dorsal sympathectomy for palmar hyperhidrosis. Use of the harmonic scalpel versus diathermy. Ann Chir Gynaecol. 2001;90:203–5.Google Scholar
  23. Lai YT, Yang LH, et al. Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. Neurosurgery. 1997;41:110–3.CrossRefPubMedGoogle Scholar
  24. Lai CL, Chen WC, Liu YB, Lee YT. Bradycardia and permanent pacing after bilateral thoracoscopic T2sympathectomy for primary hyperhidrosis. Pacing Clin Electrophysiol. 2001;24:524–5.CrossRefPubMedGoogle Scholar
  25. Lange JF. Inferior brachial plexus injury during thorascopic sympathectomy. Surg Endosc. 1995;9:830.PubMedGoogle Scholar
  26. Lin CC. http:// www.sweathand.com.
  27. Lin TS, Fang HY. Transthoracic endoscopic sympathectomy in the treatment of palmar hyperhidrosis—with emphasis on perioperative management (1,360 case analyses). Surg Neurol. 1999 Nov;52(5):453–7.CrossRefPubMedGoogle Scholar
  28. Lin CC, Telaranta T. Lin-Telaranta classification: the importance of different produce of for different indications in sympathectomy surgery. Ann Chir Gynaecol. 2001;90(3):161–6.PubMedPubMedCentralGoogle Scholar
  29. Lin C-C, Mo L-R, Hwang M-H. Intraoperative cardiac arrest: a rare complication of T2,3-sympathicotomy for treatment of hyperhidrosis palmaris. Two case reports. Eur J Surg Suppl. 1994;572:43–5.Google Scholar
  30. Lin CC, Lee LS, et al. The haemodynamic effect of thoracoscopic cardiac sympathectomy. Eur J Surg Suppl. 1998a;580:37–8.Google Scholar
  31. Lin CC, et al. Thoracoscopic T2-sympathetic block by clipping – a better and reversible operation for treatment of hyperhidrosis palmaris: experience with 326 cases. Eur J Surg Suppl. 1998b;580:13–6.Google Scholar
  32. Ojimba TA, Cameron AE. Drawbacks of endoscopic thoracic sympathectomy. Br J Surg. 2004;91(3):264–9.CrossRefPubMedGoogle Scholar
  33. Ramsaroop L, Partab P, Singh B, Satyapal KS. Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited. J Anat. 2001;199(Pt 6):675–82.CrossRefPubMedPubMedCentralGoogle Scholar
  34. Ramsaroop L, Partab P, Singh B, et al. Anatomical basis for a successful upper limb sympathectomy in the thoracoscopic era. Clin Anat. 2004;17:294–9.CrossRefPubMedGoogle Scholar
  35. Riet M, et al. Prevention of compensatory hyperhidrosis after thoracoscopic sympathectomy for hyperhidrosis. Surg Endosc. 2001;15:1159–62.CrossRefPubMedGoogle Scholar
  36. Ross JP. Sympathectomy as an experiment in human physiology. Br J Surg. 1933;21:5–19.CrossRefGoogle Scholar
  37. Shachor D, Jedeikin R, Olsfanger D, Bendahan J, Sivak G, Freund U. Endoscopic transthoracic sympathectomy in thetreatment of primary hyperhidrosis. A review of 290 sympathectomies. Arch Surg. 1994;129:241–4.CrossRefPubMedGoogle Scholar
  38. Telaranta T. Secondary sympathetic chain reconstruction after endoscopic thoracic sympathectomy. Eur J Surg. 1998;164(Suppl 580):17–8.Google Scholar
  39. Telaranta T. Reversal surgery for reducing the side-effects of ETS. A case report. Ann Chir Gynaecol. 2001;90:175–6.PubMedGoogle Scholar
  40. Zacherl J, Herbst F, et al. Video assistance reduces complication rate of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg. 1999;68:1177–81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Laert de Oliveira Andrade Filho
    • 1
  • Fabiano Cataldi Engel
    • 1
  1. 1.Hospital Israelita Albert EinsteinSão PauloBrazil

Personalised recommendations