Abstract
We report our experience on a method of endoscopic thoracic sympathectomy (ETS) reported by Claes et al. which is electrocautery of the sympathetic chain under thoracic endoscopy. We treated of thirty-five patients with palmar hyperhidrosis and three with peripheral arterial insufficiency in the upper extremities. Results were excellent for the relief of palmar hyperhidrosis and improvement of peripheral arterial insufficiency. Instead of 26Fr urological resectoscope originally used by Claes et al., we introduced small diameter hysteroresectoscope (21Fr, Olympus™) and anterior-axillar line approach at the forth intercostal space. They were useful to improve patients' cosmetical satisfaction to the surgery. The results of Claes method of ETS for both of palmar hyperhidrosis and peripheral arterial insufficiency in the upper extremities were excellent, however, we believe that we should be careful to apply the technique to treat chronic pain in the upper extremities because little scientific evidence in efficacy of ETS in patients with such pain has been established.
