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, April 30, 2011

mechanism of pulmonary edema following sympathectomy

Unilateral pulmonary edema is unusual in presentation and is mainly seen in the re-expansion phase after pneumothorax, systemic-to-pulmonary shunt, parenchymal lung disease, and unilateral sympathectomy. The mechanisms of unilateral pulmonary edema include an increase in capillary blood flow, reduced surfactant, rapid re-expansion of a collapsed lung, and disruption of venular post-capillary sphincter function after sympathectomy.1–3

many injuries to the nervous system are followed by incomplete recovery or even increasing disability over time

Many injuries to the nervous system are followed by incomplete recovery or even increasing disability over time. Some of these long term effects are due to the loss of access to growth factors called neurotrophins that provide essential support for adult nerve cells. We recently discovered that immune responses can be triggered by injury leading to inflammation around the damaged nerve cells. Control of inflammation may therefore allow the remaining nerve cells to survive until treatments that enable them to regenerate can be developed.

Wednesday, April 27, 2011

bilateral sympathectomy is often accompanied by sexual dysfunction

Current Therapy in Pain

Front Cover
Elsevier Health Sciences, 2008 - Medical - 704 pages

A certain loss of lung volume and decrease of pulmonary diffusion capacity for CO result from sympathectomy

The pathophysiology of cervical and upper thoracic sympathetic surgery

ETS "significantly decreases pulse rate and systolic blood pressure, reduces myocardial oxygen demand, increases left ventricular ejection fraction and prolongs Q-T interval. A certain loss of lung volume and decrease of pulmonary diffusion capacity for CO result from sympathectomy. Histomorphological muscle changes and neuro-histochemical and biochemical effects have also been observed."

Tuesday, April 26, 2011

Severe pain in 21.4% of patients 30 days post surgery


Successful lawyer died after procedure to cure blushing

ALAN Synnott was the country's leading solicitor specialising in personal injuries.
He had built up a large and very successful practice, but the 44-year-old father of three suffered from social phobia and facial blushing.
The blushing was interfering with his ability to speak in public and to run his office and deal with staff.
He was referred to a surgeon for an operation to stop the blushing but, during the operation, a vein and artery were damaged and massive bleeding occurred.
Emergency surgery had to be carried out and Mr Synnott, according to court papers, lost over three times his total blood volume in a 3½-hour period.
Three days later, after brain scans, he was pronounced dead.
Yesterday his grieving widow, Eleanor Synnott, settled her action for damages for €5m. "This has given me closure but no money is going to compensate me for the enormous loss of my wonderful husband and father of my children," Mrs Synnott said outside the Four Courts.
She had sued Austin Leahy, a surgeon attached to the Bon Secours Hospital, Glasnevin, Dublin, who carried out the operation over two years ago.

No significant change in tissue blood flow after sympathectomy

Lumbar sympathectomy is widely used in the treatment of peripheral vascular disease involving the lower extremity. The obvious increase in skin temperature postoperatively has led to the belief that there is a concommitant increase in perfusion of all tissues in the leg. 

Recent evidence suggests that this increase in total blood flow represents, in the main, arteriovenous shunting with a little, if any effect on the nutritive blood flow at the tissue level. Studies aimed at investigating the effect of lumbar sympathectomy on regional tissue circulation have utilized the local clearance of radioactive isotopes. No significant change in the clearance of these substances in muscle have been noted following lumbar sympathectomy in man.
Tissue Blood Flow in the Canine Lower Limb Following Lumbar SympathectomyVASC ENDOVASCULAR SURG November 1972 6227-238,

increased blood supply is associated with decreased vascular permeability

The influence of the sympathetic nervous system on capillary permeability was studied in cats. The dye penetration from the blood through the synovial membrane was tested by perfusing the two knee joints, one of which was deprived of its sympathetic nerve supply by unilateral lumbosacral
In confirmation of previous experiments, it was found in a great majority of experiments that, in spite of marked vasodilatation, the dye excretion was considerably reduced on the sympathectomised side.
A permeability factor under the influence of the sympathetic nervous system has been postulated; its character and mechanism is still unknown.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.
Res Exp Med (Berl) 173, 1--8 (1978)