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Surgical Side Effects
Possible side effects and complications of ETS
As with any surgery there are risks related to anesthesia and surgery. The most common risks are wound infection and issues related to wound healing.
Risks that are specific to Endoscopic Transthoracic Sympathectomy or ETS include:
Compensatory sweating - Increased sweating that occurs following sympathectomy surgery in parts of the body not previously affected, such as the thighs, back, abdomen and face (Gustatory sweating). Minimal increase in sweating will occur following Sympathectomy in other areas of the body in most patients, usually with exercise and in hot weather. However intractable or problematic sweating occurring in other areas of the body is reported to be around 8-10%. We have recently adopted the technique of interrupting the sympathetic chain at lower seveas opposed to the cutting maybe an option! however there is no guarantee that the condition will revert back, with the removal of the clips. Nerve grafting in excessive compensatory hyperhidrosis is a possibility, again its efficacy in reversing the problem is still questionable
Pneumothorax - A collection of air in the chest cavity after the operation. Small collections of air will resolve without treatment however larger collections could require placement of a chest tube to remove the air. (less than 1% occurrence)
Horner's Syndrome - Leads to drooping of one or both eyelids (lazy eye). In most cases, this problem goes away over a period of one to three months. However, it can be permanent. (less than 1% occurrence). This complication occurs as a result of either manipulation or heat spread at the T1 (or Stellate ganglion). With our present strategy to going lower in the sympathetic trunk (away from the T1ganglion), the use of the ultrasound instead of the electric cautery (reducing heat spread), this complication is becoming uncommon.