THORACIC SYMPATHECTOMY

The aim of the operation is to divide the sympathetic nerve chain at a level between the second and fourth thoracic sympathetic ganglia, depending on the area being treated. The surgeon operates through the chest, leaving scars on the side of the chest. A chest drain is left in place and removed the day after surgery.

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The success rate is 98% to 100%. The overall risk of complications is low. The main possible complications are listed below.

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• Dry hands.

• Slight drooping of the eyelid, which is usually temporary.

• Pain in the back or chest after surgery, which is usually temporary.

• Pneumothorax (air around the lung), which may require reinsertion of a chest drain.

• Lung complications, such as infection or a build-up of mucus, particularly if you smoke.

• Compensatory sweating is the most common side effect, affecting more than two-thirds of patients. It mainly affects the back, torso and thighs. For most patients, it is much less disruptive than the original excessive sweating. It is important to consider how common it is when deciding whether to have surgery.

• Other, less common complications include blood clots in the veins and infection at the surgical site.​

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Thoracic sympathectomy is the most effective treatment for excessive hand sweating (palmar hyperhidrosis), with excellent short-, medium- and long-term results. As with any operation, there are risks, although complications are generally minor and temporary.

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This operation is offered only to patients whose symptoms have persisted despite appropriate non-surgical treatment, including trials of both topical treatments and iontophoresis.

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For patients undergoing thoracic sympathectomy, air travel is not recommended during the first 15 days after surgery. We therefore recommend returning home by train or another suitable means of transport rather than flying during this period.For patients travelling from the UK, returning by train via Paris and Eurostar to London is a convenient option.