Skip to main content
SpringerLink
Log in

Sympatholysis via Thoracoscopy

  • Chapter
  • First Online:
Thoracoscopy for Pulmonologists

  • 1000 Accesses

Abstract

Thoracic sympathectomy is defined as the anatomical interruption of the thoracic sympathetic chain. The level of interruption (e.g., T2, T3) depends upon the indication for the sympathectomy and the required therapeutic effects (e.g., treatment of essential palmar or axillary hyperhidrosis, treatment of refractory heart rhythm disorders, treatment of chronic pancreatic pain). Anatomically, the interruption can be applied at the preganglionic level; however, current best practice involves ablation by electrocautery (“sympatholysis”) or excision/clipping of the sympathetic ganglia (and sometimes part of the chain itself) (Noppen 2004; Tassi et al. 2006).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ambrogi V, Campione E, Mineo D et al (2009) Bilateral thoracoscopic T2 to T3 sympathectomy versus botulinum injection in palmar hyperhidrosis. Ann Thorac Surg 88:238–245

    Article  PubMed  Google Scholar 

  • Assalia A, Bahouth H, Ilivitzki A (2007) Thoracoscopic sympathectomy for primary palmar hyperhidrosis: resection versus transaction – a prospective trial. World J Surg 31:1976–1979

    Article  PubMed  Google Scholar 

  • Bachmann K, Standl N, Kaifi J (2009) Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis : four-year outcome and quality of life after bilateral 5-mm dual port approach. Surg Endosc 23:1587–1593

    Article  PubMed  Google Scholar 

  • Baumgartner FJ, Bertin S, Konecny J (2009) Superiority of thoracoscopic sympathectomy over medical management for the palmoplantar subset of severe hyperhidrosis. Ann Vasc Surg 23:1–7

    Article  PubMed  Google Scholar 

  • Boutin C, Viallat JR, Aelony Y (1991) Diagnostic thoracoscopy for pleural effusions. In: Boutin C, Viallat JR, Aelony Y (eds) Practical thoracoscopy. Springer, Berlin, pp 51–64

    Chapter  Google Scholar 

  • D’Haese J, Camu F, Noppen M et al (1996) A new approach using total intravenous anaesthesia and high frequency jet ventilation during transthoracic sympathectomy for treatment of essential hyperhidrosis. J Cardiothorac Vasc Anesth 10:767–771

    Article  PubMed  Google Scholar 

  • Di Lorenzo N, Sica GS, Sileri P et al (1998) Thoracoscopic sympathectomy for vasospastic diseases. J Soc Laparoendosc Surg 2:249–253

    Google Scholar 

  • Drott C, Claes G, Olsson-Rex L et al (1998) Successful treatment of facial blushing by endoscopic transthoracic sympathicotony. Br J Dermatol 138:639–643

    Article  PubMed  CAS  Google Scholar 

  • Gossot D, Toledo L, Fritsch C et al (1997) Thoracoscopic sympathectomy for upper limb hyperhidrosis: looking for the right operation. Ann Thorac Surg 64:975–978

    Article  PubMed  CAS  Google Scholar 

  • Henteleff HJ, Kalavrouziotis D (2008) Evidence-based review of the surgical management of hyperhidrosis. Thorac Surg Clin 18:209–216

    Article  PubMed  Google Scholar 

  • Kadowaki MH, Levett JM (1986) Sympathectomy in the treatment of angina and arrhythmias. Ann Thorac Surg 41:572–578

    Article  PubMed  CAS  Google Scholar 

  • Kao MC (1992) Laser endoscopic sympathectomy for palmar hyperhidrosis. Lasers Surg Med 12:308–312

    Article  PubMed  CAS  Google Scholar 

  • Krasna MJ (2008) Thoracoscopic sympathectomy: a standardized approach to therapy for hyperhidrosis. Ann Thorac Surg 85:S764–S767

    Article  PubMed  Google Scholar 

  • Lin CC (1992) Extended thoracoscopic T2-sympathectomy in treatment of hyperhidrosis: experience with 130 consecutive cases. J Laparoendosc Surg 2:1–6

    Article  PubMed  CAS  Google Scholar 

  • Miller DL, Force SD (2008) Temporary thoracoscopic sympathetic block for hyperhidrosis. Ann Thorac Surg 85:1211–1216

    Article  PubMed  Google Scholar 

  • Mockus MB, Rutherford RB, Rosales C et al (1987) Sympathectomy for causalgia. Patient selection and long-term results. Arch Surg 122:668–672

    Article  PubMed  CAS  Google Scholar 

  • Moss AJ, Schwarz PJ, Crampton RS (1985) The long QT syndrome: a prospective international study. Circulation 71:17–22

    Article  PubMed  CAS  Google Scholar 

  • Munia M, Wolosker N, Kaufmann P et al (2008) Sustained benefit lasting one year from T4 instead of T3-T4 sympathectomy for isolated axillary hyperhidrosis. Clinics 63:771–774

    Article  PubMed  Google Scholar 

  • Neumayer C, Panhofer P, Jakesz R et al (2005) Surgical treatment of facial hyperhidrosis and blushing: mid-term results after endoscopic sympathetic block and review of the literature. Eur Surg 37:127–136

    Article  Google Scholar 

  • Noppen M (2004) Medical thoracoscopy Techniques for thoracic sympathectomy. In: Interventional pulmonary medicine. In: Beamis JF, Mathur PN, Mehta AC (eds) Lung biology in health and disease, vol 189. Marcel Dekker, New York, pp 483–502

    Google Scholar 

  • Noppen M, Vincken W (1996a) Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function. Eur Respir J 9:1660–1664

    Article  PubMed  CAS  Google Scholar 

  • Noppen M, Vincken W (1996b) Effects of thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis on bronchial responsiveness to histamine: implications on the autonomic imbalance theory of asthma. Respirology 3:195–199

    Article  Google Scholar 

  • Noppen M, Vincken W (1997) Partial pulmonary sympathetic denervation by thoracoscopic D2-D3 sympathicolysis for essential hyperhidrosis: effect on the pulmonary diffusion capacity. Respir Med 91:537–545

    Article  PubMed  CAS  Google Scholar 

  • Noppen M, Herregodts P, D’Haese J et al (1996) A simplified T2-T3 thoracoscopic sympathicolysis technique for the treatment of essential hyperhidrosis: short term results in 100 patients. J Laparoendosc Surg 6:151–159

    Article  PubMed  CAS  Google Scholar 

  • Noppen N, Sevens C, Gerlo E et al (1997a) Plasma catecholamine concentrations in essential hyperhidrosis and effects of thoracoscopic D2-D3 sympathicolysis. Eur J Clin Invest 27:202–205

    Article  PubMed  CAS  Google Scholar 

  • Noppen M, Sevens C, Vincken W (1997b) Effects of non-pharmacological sympathetic sudomotor denervation sweating in humans with essential palmar hyperhidrosis. Clin Biochem 30:171–175

    Article  PubMed  CAS  Google Scholar 

  • Noppen M, Meysman M, D’Haese J et al (1998a) Thora-coscopic splanchnicolysis for the relief of chronic pancreatic pain. Experience of a group of pulmonologists. Chest 113:528–531

    Article  PubMed  CAS  Google Scholar 

  • Noppen M, Dab I, D’Haese J et al (1998b) Thoracoscopic T2-T3 sympathicolysis for essential hyperhidrosis in childhood: effects on pulmonary function. Pediatr Pulmonol 26:262–264

    Article  PubMed  CAS  Google Scholar 

  • Sayers RD, Henner RE, Barrie WW (1994) Transthoracic endoscopic sympathectomy for hyperhidrosis and Raynaud’s phenomenon. Eur J Vasc Surg 8:627–631

    Article  PubMed  CAS  Google Scholar 

  • Schott GD (1998) Interrupting the sympathetic outflow in causalgia and reflex sympathetic dystrophy. A futile procedure for many patients. Br Med J 316:792–793

    Article  CAS  Google Scholar 

  • Sciuchetti JF, Corti F, Ballabio D et al (2008) Results, side effects and complications after thoracoscopic sympathetic block by clamping. Clin Auton Res 18:80–83

    Article  PubMed  Google Scholar 

  • Steiner Z, Cohen Z, Kleiner O (2008) Do children tolerate thoracoscopic sympathectomy better than adults? Pediatr Surg Int 24:343–347

    Article  PubMed  Google Scholar 

  • Sugimura H, Spratt EH, Compeau CG et al (2009) Thoracoscopic sympathetic clipping for hyperhidrosis: long-term results and reversibility. J Thorac Cardiovasc Surg 137:1370–1378

    Article  PubMed  Google Scholar 

  • Tassi GF, Davies RJ, Noppen M (2006) Advanced techniques in medical thoracoscopy. Eur Respir J 28:1051–1059

    Article  PubMed  CAS  Google Scholar 

  • Wettervik C, Claes G, Drott C et al (1995) Endoscopic transthoracic sympathicotomy for severe angina. Lancet 345:97–98

    Article  PubMed  CAS  Google Scholar 

  • Wilkinson HA (1984) Radio frequency percutaneous upper thoracic sympathectomy technique and review of indications. N Engl J Med 311:34–36

    Article  PubMed  CAS  Google Scholar 

  • Wolosker N, Yazbek G, Ishy A et al (2008) Is sympathectomy at T4 level better than at T3 level for treating palmar hyperhidrosis? J Laparoendosc Adv Surg Tech 18:102–106

    Article  Google Scholar 

  • Yamamoto H, Kanehira A, Kawamura M et al (2000) Needlescopic surgery for palmar hyperhidrosis. J Thorac Cardiovasc Surg 120:276–279

    Article  PubMed  CAS  Google Scholar 

  • Yim APC, Liu HP, Lee TW et al (2000) ‘Needlescopic’ video-assisted thoracic surgery for palmar hyperhidrosis. Eur J Cardiothorac Surg 17:697–701

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Interventional Endoscopy Clinic, University Hospital UZ Brussel, Brussels, Belgium

    Marc Noppen

Authors
  1. Marc Noppen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marc Noppen .

Editor information

Editors and Affiliations

  1. Pleural Diseases Interventional Pulmonology, Hôpital Nord Division of Thoracic Oncology, Marseille cedex 20, France

    Philippe Astoul

  2. Divisione di Pneumologia, Spedali Civili di Brescia, Brescia (BS), Italy

    GianFranco Tassi

  3. Département de Médecine Interne, Centre valaisan de pneumologie, CHCVs, Montana, Switzerland

    Jean-Marie Tschopp

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Noppen, M. (2014). Sympatholysis via Thoracoscopy. In: Astoul, P., Tassi, G., Tschopp, JM. (eds) Thoracoscopy for Pulmonologists. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38351-9_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38351-9_19

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38350-2

  • Online ISBN: 978-3-642-38351-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation