Indications for endoscopic thoracic sympathectomy.

The thoracoscopic approach to the sympathetic chain has diminished the trauma of previous open sympathectomy. The minimal trauma has opened the way to manipulate the chain for several conditions. Hand sweat is the most common indication resulting in patient satisfaction 2-13 years after surgery in more than 90%. High satisfaction was also obtained in patients with angina pectoris and a very disabling condition, facial blushing (85 %). Somewhat poorer results were obtained in patients with facial and axillary sweating. In patients with Mb Raynaud-all had recurrences within a year. Since severe side effects, especially compensatory sweating, may occur, the ETS procedure should be reserved only for patients with severe problems where other treatments have failed.