Return to Search
EN
Endoscopic Thoracic Sympathectomy (ETS) is a surgical procedure, and like all surgical interventions, it carries inherent risks and potential complications. Patients considering ETS should be thoroughly informed about these possibilities. Key complications include:
* Compensatory Hyperhidrosis (CH) / Reflex Hyperhidrosis: This is the most frequently encountered and often most distressing complication. It involves an increase in sweating in other areas of the body post-surgery. While the precise mechanism is not fully understood, it is more commonly observed when the sympathetic chain levels 2 and 3 are targeted. Management often involves further intervention at sympathetic chain levels 3 or 4. Comprehensive pre-operative counseling regarding this risk is crucial.
* Pneumothorax (Collapsed Lung due to trapped air): This can occur if the lung tissue is inadvertently damaged during the procedure, allowing air to escape into the thoracic cavity. Alternatively, incomplete evacuation of air before awakening the patient can also lead to air retention within the chest.
* Bleeding: As with any surgical procedure, there is a risk of intraoperative or postoperative bleeding.
* Bradycardia (Slow Heart Rate): The sympathetic nerves targeted in ETS also play a role in regulating heart rate. Blockage at surgical levels (typically 2-5) can lead to a decrease in heart rate. In severe cases, significant bradycardia can be a life-threatening complication. To mitigate this risk, the patient's heart rate is closely monitored pre-operatively. If the pre-operative heart rate is between 50-60 beats per minute, a unilateral procedure might be considered. Post-operatively, following a unilateral procedure, the heart rate is re-evaluated. A bilateral procedure should not be performed if the heart rate drops below 50 beats per minute.
What are the risks of hyperhidrosis surgery (ETS)?
* Compensatory Hyperhidrosis (CH) / Reflex Hyperhidrosis: This is the most frequently encountered and often most distressing complication. It involves an increase in sweating in other areas of the body post-surgery. While the precise mechanism is not fully understood, it is more commonly observed when the sympathetic chain levels 2 and 3 are targeted. Management often involves further intervention at sympathetic chain levels 3 or 4. Comprehensive pre-operative counseling regarding this risk is crucial.
* Pneumothorax (Collapsed Lung due to trapped air): This can occur if the lung tissue is inadvertently damaged during the procedure, allowing air to escape into the thoracic cavity. Alternatively, incomplete evacuation of air before awakening the patient can also lead to air retention within the chest.
* Bleeding: As with any surgical procedure, there is a risk of intraoperative or postoperative bleeding.
* Bradycardia (Slow Heart Rate): The sympathetic nerves targeted in ETS also play a role in regulating heart rate. Blockage at surgical levels (typically 2-5) can lead to a decrease in heart rate. In severe cases, significant bradycardia can be a life-threatening complication. To mitigate this risk, the patient's heart rate is closely monitored pre-operatively. If the pre-operative heart rate is between 50-60 beats per minute, a unilateral procedure might be considered. Post-operatively, following a unilateral procedure, the heart rate is re-evaluated. A bilateral procedure should not be performed if the heart rate drops below 50 beats per minute.