Why Endoscopic Thoracic Sympathectomy Should be your Last Option
Endoscopic thoracic sympathectomy is a surgical intervention commonly perceived as the treatment of hyperhidrosis. In this procedure, the sympathetic chain of nerves in the thoracic cavity that regulates the blood supply to the skin and function of the glands that are responsible for producing sweat is interrupted. The sympathetic chain is either clamped or cut to terminate excessive activity leading to increased sweating.
Like any other surgical procedure, this intervention is also not without its risks and adverse effects. ETS has both the usual risks of surgery such as bleeding, infection, failure, etc. as well as certain specific risks. First of all, it is an expensive procedure with limited success and not affordable for everyone (around $10,000). It is performed under general anesthesia which has its own lists of side effects including vomiting, nausea, confusion, sore throat, dizziness, chills and shivering, muscle aches, respiratory issues, bladder problems, drug-related adverse effects, etc.
ETS should be considered as the last resort for treating hyperhidrosis in the light of the fact that it can cause some serious, irreversible, and crippling effects, for example, exaggerated hypotension, heat intolerance, and arrhythmias. It can also alter the physiological response to emotions, for example, laughter and fear, lessen the body’s physical response to both torment and joy, and also restraint skin sensations such as goosebumps. Patients undergoing this surgery can also develop compensatory sweating that is excessive and occurs on the chest, abdomen, back, legs, buttocks, and/or face after ETS. It can be equal to or significantly even more than the initial sweating problem. A significant decrement in alertness, fear, and arousal was also demonstrated in a study conducted on psychiatric patients. Arousal is fundamental to awareness, in controlling information processing and attention, emotion, and memory.
A severe possible consequence of ETS surgery is Corposcindosis, also called Split Body Syndrome in which the person feels that he/she is living in two distinct bodies as the sympathetic nerve function has been partitioned into 2 separate regions, one hyperactive and the other dead.
As a matter of fact, most doctors do not suggest ETS surgery on account of the serious negative side effects. Consulting with a dermatologist is recommended before heading towards the surgery. A dermatologist can offer effective non-surgical treatment options as opposed to ETS. Before jumping to ETS, the physicians and their patients should make sure that they have adequately tried all the other available treatment modalities, including antiperspirants, iontophoresis alone or with a combination of anticholinergics, botox injections or combination of these. In short; if you or someone you care for is opting for ETS to treat hyperhidrosis, serious caution should be taken, and extensive research should precede the decision in order to avoid any long-term negative effects and regrets.