Slovenská chirurgia 2/2012

Upper thoracic sympathectomy: indications and techniques

Videothoracoscopic upper thoracic sympathectomy is a standard procedure in treatment of palmar and axillary hyperhidrosis. In last decades other indications have been introduced and modified. Nowadays the patients suffering from the facial blush, vascular disorders or the early stages of complex regional pain syndrome benefit from this surgery. The sympathectomy has been also described for the treatment of other rare conditions such as intractable angina pectoris or long QT syndrome. Howewer there is still discussion on the optimal technique of the sympathetic chain destruction or ablation and the extent of the procedure with regard to achieve good short and long term results on one hand and to minimise the side effects on the other hand. Videothoracoscopic sympathectomy is safe and undemanding procedure. Properly indicated patients tolerate it well and are satisfied with the results.

Keywords: upper thoracic sympathectomy, videothoracoscopic sympathectomy, palmar hyperhidrosis, axillary hyperhidrosis, facial blush, complex regional pain syndrome, long QT syndrome, compensatory sweating, Raynaud phenomenon, Bürger disease.