The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.

Spinal cord infarction occurring during thoraco-lumbar sympathectomy
J Neurol Neurosurg Psychiatry 1963;26:418-421 doi:10.1136/jnnp.26.5.418

Saturday, March 26, 2011

after unilateral sympathectomy found that his previous and customary sensation of shivering while listening to a stirring passage of music occurred in only one side

Sweet* has reported the case of a very intelligent patient, the dean of a graduate school, who after a unilateral sympathectomy to treat his upper limb hyperhidrosis, found that his previous and customary sensation of shivering while listening to a stirring passage of music occurred in only one side and he could not be thrilled in the sympathectomized half of his body. These cases were interesting because emotions are usually experienced in a rather diffuse and bilateral fashion unless innervation has been specifically interrupted. (p.134.)
Jose M.R. Delgado, M.D.
Physical control of the mind,
Harper Torchbooks, Harper & Row Publishers, 1971

*Sweet, W.H. Participant in "Brain Stimulation in Behaving Subjects". Neurosciences Research Program Workshop. Dec. 1966

Thursday, March 24, 2011

Patients who have undergone sympathectomy are not suitable controls. Why?

Again, patients admitted with any malignancy, cholecystectomy, 
thyroidectomy, renal disease, cardiac disease, sympathectomy, or 
vascular graft were eliminated as controls. 

This article reviews the evidence that neuroleptics may increase the risk of breast 
cancer via their effects on prolactin secretion. 

Paul M. Schyve; Francine Smithline; Herbert Y. Meltzer 
Neuroleptic-induced Prolactin Level Elevation and Breast 
Cancer: An Emerging Clinical Issue 
Arch Gen Psychiatry, Nov 1978; 35: 1291 - 1301. 

Chest wall paresthesia affects a significant but previously overlooked proportion of patients following sympathectomy

Paresthetic discomfort distinguishable from wound pain was described by 17 patients (50.0%). The most common descriptions were of ‘bloating’ (41.2%), ‘pins and needles’(35.3%), or ‘numbness’ (23.5%) in the chest wall. The paresthesia resolved in less than two months in 12 patients (70.6%), but was still felt for over 12 months in three patients (17.6%). Post-operative paresthesia and pain did not impact on patient satisfaction with the surgery, whereas compensatoryhyperhidrosis in 24 patients (70.6%) did (P=0.001). The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS. Conclusions: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS.
Eur J Cardiothorac Surg 2005;27:313-319

Wednesday, March 23, 2011

sympathectomy controversial

"This is a field in which the unknown is still substantial and the some of the known -  controversial."
M. Hashmonai, 2005
President of the International Society of Sympathetic Surgery

Volume 15, Number 2130-145DOI: 10.1007/s10286-005-0271-x