{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:49:18Z","timestamp":1783662558547,"version":"3.55.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2008,8,13]],"date-time":"2008-08-13T00:00:00Z","timestamp":1218585600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Video-Assisted Thoracoscopic Sympathectomy (VATS) is an established minimally invasive procedure for thoracic sympathetic blockade in patients with hyperhidrosis, facial flushing and intractable angina. Various techniques using clips, diathermy and excision are used to perform sympathectomy. We present our technique of excision of the sympathetic chain with histological proof and the analysis of the early and late outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We evaluated 200 procedures in 100 consecutive patients, who underwent Video Assisted Thoracoscopic Sympathectomy by a single surgeon in our centre between September 1996 to March 2007. All patients had maximum medical therapy prior to surgery and were divided into 3 groups based on indications, Group 1(hyperhidrosis: 48 patients), Group 2 (facial flushing: 26 patients) and Group 3(intractable angina: 26 patients). The demography and severity of symptoms for each group were analysed. The endpoints were success rate, 30 day mortality, complications and patient's satisfaction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>99 patients had bilateral VATS sympathectomy and 1 had unilateral sympathectomy. The conversion rate to open was 1(1%). All patients had successful removal of ganglia proven histologically with no perioperative mortality in our series. The complications included pneumothorax (5%), acute coronary syndrome (2%), transient Horner's syndrome (1%), transient paraesthesia (1%), wound infection (4%), compensatory hyperhidrosis (18%), residual flushing (3%) and wound pain (5%). There were five late deaths in the intractable angina group at a mean follow up of 36.7 months. Overall success rates of abolishing the symptoms were 96.3%, 87.5% and 95.2% for Group 1, 2 and 3 respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Excision of the sympathetic chain with histological confirmation during VATS sympathectomy is a safe and effective method in treating hyperhidrosis, facial flushing and intractable angina with good long term results and satisfaction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1749-8090-3-50","type":"journal-article","created":{"date-parts":[[2008,8,13]],"date-time":"2008-08-13T18:13:51Z","timestamp":1218651231000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Excision of sympathetic ganglia and the rami communicantes with histological confirmation offers better early and late outcomes in Video assisted thoracoscopic sympathectomy"],"prefix":"10.1186","volume":"3","author":[{"given":"Sridhar","family":"Rathinam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Nanjaiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivakumar","family":"Sivalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pala B","family":"Rajesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2008,8,13]]},"reference":[{"key":"150_CR1","first-page":"585","volume":"35","author":"J Hughes","year":"2008","unstructured":"Hughes J: Endothoracic sympathectomy. Proc R Soc Med. 2008, 35: 585-586.","journal-title":"Proc R Soc Med"},{"key":"150_CR2","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1055\/s-0028-1115011","volume":"78","author":"E KUX","year":"1953","unstructured":"KUX E: 1239 Cases of thorascopic sympathectomy and vagotomy; preliminary report. Dtsch Med Wochenschr. 1953, 78: 1590-1592.","journal-title":"Dtsch Med Wochenschr"},{"key":"150_CR3","first-page":"377","volume":"2","author":"TS Lin","year":"2001","unstructured":"Lin TS, Wang NP, Huang LC: Pitfalls and complication avoidance associated with transthoracic endoscopic sympathectomy for primary hyperhidrosis (analysis of 2200 cases). Int J Surg Investig. 2001, 2: 377-385.","journal-title":"Int J Surg Investig"},{"key":"150_CR4","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1016\/j.athoracsur.2005.12.017","volume":"81","author":"PB Licht","year":"2006","unstructured":"Licht PB, Ladegaard L, Pilegaard HK: Thoracoscopic sympathectomy for isolated facial blushing. Ann Thorac Surg. 2006, 81: 1863-1866. 10.1016\/j.athoracsur.2005.12.017.","journal-title":"Ann Thorac Surg"},{"key":"150_CR5","first-page":"19","volume-title":"Eur J Surg Suppl","author":"MJ Krasna","year":"1998","unstructured":"Krasna MJ, Demmy TL, McKenna RJ, Mack MJ: Thoracoscopic sympathectomy: the U.S. experience. Eur J Surg Suppl. 1998, 19-21. 10.1080\/11024159850191085."},{"key":"150_CR6","doi-asserted-by":"publisher","first-page":"S95","DOI":"10.1016\/S1010-7940(99)00197-9","volume":"16 Suppl 1","author":"SS Khogali","year":"1999","unstructured":"Khogali SS, Miller M, Rajesh PB, Murray RG, Beattie JM: Video-assisted thoracoscopic sympathectomy for severe intractable angina. Eur J Cardiothorac Surg. 1999, 16 Suppl 1: S95-S98. 10.1016\/S1010-7940(99)00197-9.","journal-title":"Eur J Cardiothorac Surg"},{"key":"150_CR7","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.ejcts.2006.04.016","volume":"30","author":"MO Murphy","year":"2006","unstructured":"Murphy MO, Ghosh J, Khwaja N, Murray D, Halka AT, Carter A, Turner NJ, Walker MG: Upper dorsal endoscopic thoracic sympathectomy: a comparison of one- and two-port ablation techniques. Eur J Cardiothorac Surg. 2006, 30: 223-227. 10.1016\/j.ejcts.2006.04.016.","journal-title":"Eur J Cardiothorac Surg"},{"key":"150_CR8","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1111\/j.1473-2130.2004.00126.x","volume":"3","author":"OP Kreyden","year":"2004","unstructured":"Kreyden OP: Iontophoresis for palmoplantar hyperhidrosis. J Cosmet Dermatol. 2004, 3: 211-214. 10.1111\/j.1473-2130.2004.00126.x.","journal-title":"J Cosmet Dermatol"},{"key":"150_CR9","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/S0140-6736(95)90065-9","volume":"345","author":"C Wettervik","year":"1995","unstructured":"Wettervik C, Claes G, Drott C, Emanuelsson H, Lomsky M, Radberg G, Tygesen H: Endoscopic transthoracic sympathicotomy for severe angina. Lancet. 1995, 345: 97-98. 10.1016\/S0140-6736(95)90065-9.","journal-title":"Lancet"},{"key":"150_CR10","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1007\/BF00257681","volume":"13","author":"P Toft","year":"1987","unstructured":"Toft P, Jorgensen A: Continuous thoracic epidural analgesia for the control of pain in myocardial infarction. Intensive Care Med. 1987, 13: 388-389. 10.1007\/BF00257681.","journal-title":"Intensive Care Med"},{"key":"150_CR11","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1097\/00000542-199011000-00008","volume":"73","author":"S Blomberg","year":"1990","unstructured":"Blomberg S, Emanuelsson H, Kvist H, Lamm C, Ponten J, Waagstein F, Ricksten SE: Effects of thoracic epidural anesthesia on coronary arteries and arterioles in patients with coronary artery disease. Anesthesiology. 1990, 73: 840-847. 10.1097\/00000542-199011000-00008.","journal-title":"Anesthesiology"},{"key":"150_CR12","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/S0003-4975(00)01489-2","volume":"70","author":"PM Goh","year":"2000","unstructured":"Goh PM, Cheah WK, De CM, Sim EK: Needlescopic thoracic sympathectomy: treatment for palmar hyperhidrosis. Ann Thorac Surg. 2000, 70: 240-242. 10.1016\/S0003-4975(00)01489-2.","journal-title":"Ann Thorac Surg"},{"key":"150_CR13","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/S1010-7940(01)01042-9","volume":"21","author":"D Lardinois","year":"2002","unstructured":"Lardinois D, Ris HB: Minimally invasive video-endoscopic sympathectomy by use of a transaxillary single port approach. Eur J Cardiothorac Surg. 2002, 21: 67-70. 10.1016\/S1010-7940(01)01042-9.","journal-title":"Eur J Cardiothorac Surg"},{"key":"150_CR14","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/S1010-7940(96)80292-2","volume":"10","author":"EN Yilmaz","year":"1996","unstructured":"Yilmaz EN, Dur AH, Cuesta MA, Rauwerda JA: Endoscopic versus transaxillary thoracic sympathectomy for primary axillary and palmar hyperhidrosis and\/or facial blushing: 5-year-experience. Eur J Cardiothorac Surg. 1996, 10: 168-172. 10.1016\/S1010-7940(96)80292-2.","journal-title":"Eur J Cardiothorac Surg"},{"key":"150_CR15","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1097\/00000658-199407000-00012","volume":"220","author":"F Herbst","year":"1994","unstructured":"Herbst F, Plas EG, Fugger R, Fritsch A: Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations. Ann Surg. 1994, 220: 86-90. 10.1097\/00000658-199407000-00012.","journal-title":"Ann Surg"},{"key":"150_CR16","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1007\/s004640080107","volume":"15","author":"TS Lin","year":"2001","unstructured":"Lin TS: Endoscopic clipping in video-assisted thoracoscopic sympathetic blockade for axillary hyperhidrosis. An analysis of 26 cases. Surg Endosc. 2001, 15: 126-128. 10.1007\/s004640080107.","journal-title":"Surg Endosc"},{"key":"150_CR17","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/0190-9622(95)90015-2","volume":"33","author":"C Drott","year":"1995","unstructured":"Drott C, Gothberg G, Claes G: Endoscopic transthoracic sympathectomy: an efficient and safe method for the treatment of hyperhidrosis. J Am Acad Dermatol. 1995, 33: 78-81. 10.1016\/0190-9622(95)90015-2.","journal-title":"J Am Acad Dermatol"},{"key":"150_CR18","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1067\/mtc.2002.119340","volume":"123","author":"IH Chung","year":"2002","unstructured":"Chung IH, Oh CS, Koh KS, Kim HJ, Paik HC, Lee DY: Anatomic variations of the T2 nerve root (including the nerve of Kuntz) and their implications for sympathectomy. J Thorac Cardiovasc Surg. 2002, 123: 498-501. 10.1067\/mtc.2002.119340.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"150_CR19","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1097\/00007611-195108000-00001","volume":"44","author":"A Kuntz","year":"1951","unstructured":"Kuntz A: Afferent innervation of peripheral blood vessels through sympathetic trunks; its clinical implications. South Med J. 1951, 44: 673-678.","journal-title":"South Med J"},{"key":"150_CR20","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1002\/bjs.1800790329","volume":"79","author":"M Hashmonai","year":"1992","unstructured":"Hashmonai M, Kopelman D, Kein O, Schein M: Upper thoracic sympathectomy for primary palmar hyperhidrosis: long-term follow-up. Br J Surg. 1992, 79: 268-271. 10.1002\/bjs.1800790329.","journal-title":"Br J Surg"},{"key":"150_CR21","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/00006123-199707000-00023","volume":"41","author":"YT Lai","year":"1997","unstructured":"Lai YT, Yang LH, Chio CC, Chen HH: Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. Neurosurgery. 1997, 41: 110-113. 10.1097\/00006123-199707000-00023.","journal-title":"Neurosurgery"},{"key":"150_CR22","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1017\/S0266462307051574","volume":"23","author":"A Malmivaara","year":"2007","unstructured":"Malmivaara A, Kuukasjarvi P, utti-Ramo I, Kovanen N, Makela M: Effectiveness and safety of endoscopic thoracic sympathectomy for excessive sweating and facial blushing: a systematic review. Int J Technol Assess Health Care. 2007, 23: 54-62. 10.1017\/S0266462307051574.","journal-title":"Int J Technol Assess Health Care"},{"key":"150_CR23","first-page":"2526","volume":"167","author":"PB Licht","year":"2005","unstructured":"Licht PB, Pilegaard HK: Compensatory sweating after sympathectomy for hyperhidrosis--secondary publication. Ugeskr Laeger. 2005, 167: 2526-2528.","journal-title":"Ugeskr Laeger"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-50.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1749-8090-3-50\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-50","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-50.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:28:41Z","timestamp":1630456121000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/1749-8090-3-50"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,8,13]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2008,12]]}},"alternative-id":["150"],"URL":"https:\/\/doi.org\/10.1186\/1749-8090-3-50","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,8,13]]},"assertion":[{"value":"21 January 2008","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2008","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2008","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"50"}}