Effects of clipping endoscopic thoracal sympathectomy at Th4 on cardiopulmonary functions, quality of life and psychosocial functions

  • Gurhan OzEmail author
  • Ersin Gunay
  • Ahmet Dumanli
  • Sule Cilekar
  • Bengu Yucens
  • Serkan Gokaslan
  • Elif Dogan Baki
Original Article



In this study, we evaluated the cardiopulmonary and psychosocial effects of endoscopic thoracal sympathectomy (ETS) by clipping procedure at the level of Th4 and effects of ETS on quality of life of patients with hyperhidrosis.


We performed a prospective study in 52 patients complaining of local sweating who applied to our clinic. Cardiac maximal treadmill stress test (CMTST), pulmonary function tests, Beck anxiety–depression inventory, Liebowitz social anxiety scale and SF-36 quality of life questionnaires were administered at preoperative period and postoperative 6th month.


In the pulmonary function test, we found a minimal decrease in FEV1, and FEV1/FVC. There were no significant change in ‘resting pulse rate’, ‘resting systolic and diastolic blood pressures’ during CMTST between before and after operation. There was a significant difference in peak heart rate before CMTST, post-exercise diastolic blood pressure, and age-predictive maximal heart rate between before and after clipping procedure. In the SF-36 questionnaire, all parameters were improved. In the Beck depression–anxiety inventory and the Liebowitz social anxiety scale significant improvement was achieved in all parameters.


ETS by clipping procedure at the Th4 level is advised to be a safe and effective method for management of hyperhidrosis patients.


Sympathectomy Hyperhidrosis Cardiopulmonary functions Psychosocial functions 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest in association with the present study.


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Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  • Gurhan Oz
    • 1
    Email author
  • Ersin Gunay
    • 2
  • Ahmet Dumanli
    • 1
  • Sule Cilekar
    • 2
  • Bengu Yucens
    • 3
  • Serkan Gokaslan
    • 4
  • Elif Dogan Baki
    • 5
  1. 1.Department of Thoracic SurgeryAfyon Kocatepe University School of MedicineAfyonkarahisarTurkey
  2. 2.Department of Chest Diseases, School of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey
  3. 3.Department of Psychiatry, School of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey
  4. 4.Department of Cardiology, School of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey
  5. 5.Department of Anesthesiology, School of MedicineAfyon Kocatepe UniversityAfyonkarahisarTurkey

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