http://www.ssmonline.org/News/ViewRelease.asp?ReleaseID=4295

2/5/2004  

February 5, 2004: ETS Carries Unrecognized Risk of Complications
A recent investigation of morbidity and mortality associated with the increasingly common endoscopic thoracic sympathectomy (ETS) reveals that the procedure can be accompanied by dangerous complications and a level of patient dissatisfaction with the results. The findings are published online in the British Journal of Surgery.1 
Endoscopic thoracic sympathectomy, which is used to correct palmar hyperhidrosis (ie, sweaty palms), facial sweating, and blushing, is considered by some to be a lifestyle procedure akin to aesthetic plastic surgery and to be medically unnecessary. Although no death following ETS has ever been reported in the literature, authors of this study learned of nine anecdotal fatalities, including five from massive internal bleeding and three from anesthetic mishap.

The most common complication experienced by recipients of ETS is compensatory sweating in a range of bodily locations. Two separate reports indicated 97% and 100% of patients who underwent ETS experienced this problem, and it has led to some patients regretting the surgery. Less commonly reported complications include Horners syndrome, rhinitis, phantom sweating, and cardiorespiratory effects. 

The absence of a single death reported in any published series indicates that when performed in experienced centers, ETS is a safe procedure. The authors, however, wish to convey the need for a note of caution when approaching the possibility of ETS. Lead author and consultant surgeon Alan Cameron said, Sweating and flushing are very distressing conditions and are often helped by ETS, but patients need to consider for themselves the risks and benefits and be particularly cautious in assessing unregulated information on the web.

Based on these results, it is clear that further improvements are needed in both surgical technique and patient screening to make ETS a universally safe and successful procedure.

1. Drawbacks of endoscopic thoracic sympathectomy, by T.A. Ojimba and A.E.P. Cameron; British Journal of Surgery. DOI: 10.1002/bjs.4511 

 
 
