FACIAL HYPERHIDROSIS

We have found a 98% relief of facial hyperhidrosis, in patients treated by us, by Videothoracoscopic Sympathectomy. Scientific literature reports similar results, (95%), recurrent cases being only 8% in some series. In these cases, Compensatory Hyperhidrosis could be more frequent, according to some authors. 

FACIAL BLUSH

As an interesting fact, this kind of pathology was historically first described by the British naturalist Charles Darwin. It is mainly caused by emotional factors, about 70% of patients suffering from it also have some degree of social phobia. Our team has accomplished a 95% relief of facial blush, in patients treated by Videothoracoscopic Sympathectomy. According to scientific literature, 85% of patients are satisfied with results. 

ANGINA PECTORIS

Sympathectomy has proved to be very useful when treating patients with severe pre-cordial pain, due to cardiac ischemia, which can not be treated by coronary by-passes or angioplasty. A study published in The Lancet, British prestigious medical magazine, reports that in 135 patients, 50% got a total relief, 40% got partial results, and 10% did not get any changes. 

Mortality did not increase as a result of the procedure. Besides, results show an improvement in the depression of segment ST in the Electrocardiogram, which means a reduction of myocardial ischemia. 

ARTERIAL INSUFFICIENCY IN UPPER MEMBERS 

Thoracoscopic Sympathectomy has shown excellent results in treating and saving upper members that suffer arterial insufficiency caused by trauma, arteriosclerosis, cytostatic drugs, etc…, when a reconstruction can not be intended because of a previous distal illness (palmar or digital arteries)

RAYNAUD’S DISEASE

Relief obtained by Thoracoscopic Sympathectomy is usually temporary, there are frequent relapses, generally one year after surgery. Definitive relief is just slight. So, this procedure is just relatively indicated in treating this disease.

COMPLEX REGIONAL PAIN SYNDROME

It is defined as a disproportionate pain, which comes together with autonomic dysfunction, edema, dystrophy or atrophy, as a result of trauma, surgery, a vascular problem or without an established cause. This syndrome is a major problem for patients and physicians; many treatments have been used, but none of them has proved to be of real therapeutic value. It can be classified in two major types: 

Type 1. There is no specific nervous lesion. It comes together with temporary osteoporosis and acute osseous atrophy. It includes disorders such as Reflex Sympathetic Dystrophy, Sudeck’s Atrophy, and the Shoulder-Hand Syndrome. 

Type 2. There is a nervous lesion: Causalgia.  

Videothoracoscopic Sympathectomy, resecting T2 – T5, has been very successful in dealing with this pathology. Several studies show clear results,concerning relief from pain: There is a nearly complete cure, for pain that happens in rest, and a reduction of pain that is due to repeated movements. 

Most patients were able to suspend their intake of analgesics and also restart their daily activities, which really improved their life quality. The fact that just a few patients respond well to the blockade, with a needle, of the Starred Ganglion (Sympathetic C7- T1), has made unusual the practice of Videothoracoscopic Sympathectomy for dealing with this pathology. However, as the sympathetic system is completely denerved with surgery, which blocking by a needle alone does not achieve, Simpathectomy has better results. 

Patients treated with Sympathectomy return to work much earlier and are able to start Physical Therapy earlier. This treatment also means big money savings.

SYNDROME OF A CONGENITAL PROLONGED QT

It is usually accompanied by a big risk of Ventricular Arrhythmias, Syncope and sudden death. Usual treatments consist on Beta- Blockers. These do not help 30% of patients, who continue suffering from risks and syncope. A major open surgery, Cardiac Sympathectomy, has proved to be successful, but due to its difficulties, it is not usually performed. 

Videothoracoscopic Sympathectomy is a much less aggressive and risky procedure; it allows a resection of ganglions T2- T5 and the inferior 1/3 of the starred ganglion. Some studies have proved the immediate partial reduction of the QT segment in 3 out of 4 patients (as shown in the Electrocardiogram) and the complete disappearance of arrhythmias and syncope in 4 out of 4 patients. 

It is very important to consider Videothoracoscopic Sympathectomy as the definitive replacement of Beta-Blockers when treating patients with Prolonged QT, who are in risk of Arrhythmias, Syncope and Sudden Death.