Unsubstantiated statements by ETS surgeon can be misleading

"The incidence of compensatory hyperhidrosis is
proportional to
the surface
area rendered anhidrotic."


"The statement is based on my own observations.  It is
original and does not refer to any other article.
You have already discovered the
original source.

It is a clinical observation.  I have done no
measurements that is/yet to be subjected to
scientific study.
You can quote it as a clinical
hypothesis that I have postulated."

Jack Collin,
consultant surgeon
Oxford

Mia: the only study done (and posted on this blog)
so far, states that 
Sympathectomy will INCREASE the total
amount of body sweat.
http://www.ncbi.nlm.nih.gov/pubmed/11193740

Sympathectomy - division of adrenergic, cholinergic and sensory fibres

In general sympathectomy has been used for one or more of the following purposes:
1) to eliminate tonic or engendered responses which depend upon impulses in adrenergic nerves;
2) to eliminate visceral stores or adrenergic substances which depend upon the integrity of the postganglionic sympathetic innervation;
3) to eliminate postganglionic sympathetic tissue as a locus for the synthesis, uptake, binding, release and metabolism of adrenergic substances;
4) to eliminate visceral afferent fibers which are frequently distributed in common with autonomic nerves. The extent to which the surgical procedure is adjudged successful is usually related to the anatomical extent of the denervation and the time after operation at which the result is evaluated.
It is clear that "sympathectomy" is not a selective excision of adrenergic elements only. It is well recognized that preganglionic sympathectomy involves division of cholinergic elements ad sensory fibers.
Pharmacological Reviews, 1966 Vol. 18, No. 1. Part I

Bilateral surgical sympathectomy provides a valuable tool for future investigations of the cellular basis of supersensitivity in the myocardium.

K Goto, PA Longhurst, LA Cassis, RJ Head, DA Taylor, PJ Rice and WW Fleming

Volume 234, Issue 1, pp. 280-287, 07/01/1985
Copyright © 1985 by American Society for Pharmacology and Experimental Therapeutics

Autonomic dysreflexia

Autonomic dysreflexia is a potentially life-threatening complication in these patients. This disorder represents an autonomic response, which is primarily sympathetic, to specific visceral stimuli in patients with spinal cord injury above the level of T6. An incomplete compensatory parasympathetic outflow will occur above the level of injury. This phenomena is more common in patients with cervical injuries, and common triggers include bowel and bladder distention. Symptoms may involve piloerection, diaphoresis, pounding headache, flushing above the level of the injury, and may be associated with sudden and severe hypertension accompanied by reflex bradycardia. Although bradycardia is most common, tachycardia and arrhythmias may be present. Hypertension may be of varying severity from causing a mild headache to a seixure or life-threatening cerebral hemorrhage.

Voiding Dysfunction

By Rodney A. Appell
Published by Humana Press, 2000

Hypotension

Orthostatic hypotension is commonly associated with prolonged bed rest (24 hours or longer). It may also result from sympathectomy, which disrupts normal vasoconstrictive mechanisms.

READ BOOK EXCERPT ONLINE »

Orthostatic hypotension [Postural hypotension]: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

reduction of catecholamines by more than 90%

Sympathectomy has been used to study the role of the sympathetic nervous system in the control of gastric acid secretion. Conflicting results may reflect differences in the sympathectomy procedures used. In a previous study we showed a reduction of catecholamines by more than 90% in the gut wall of the rat after surgical upper abdominal sympathectomy.

Total denervation, including combined surgical and chemical sympathectomy plus vagotomy, did not reduce noradrenaline levels more than surgical sympathectomy alone, suggesting that the proportion of adrenergic fibers that derive from the vagus is quantitatively insignificant but that the vagus exerts a local control of the sympathetic stores of gastric catecholamines. Thus, surgical upper abdominal sympathectomy is the method of choice in studies of the role of the sympathetic nervous system in regulating gastric functions. Adrenaline and dopamine levels were much lower than the noradrenaline levels but showed roughly the same trends of changes after the denervations (except that chemical sympathectomy did not affect dopamine).
Scandinavian Journal of Gastroenterology, Volume 20, Issue 10 December 1985 , pages 1276 - 1280
H. Graffner ^a; M. Ekelund ^a; R. Hkanson ^a; E. Rosengren ^a

Affiliation:

a Depts. of Surgery and Pharmacology, University of Lund, Lund, Sweden

Serum Dopamine-β -Hydroxylase: Decrease after Chemical Sympathectomy

Dopamine-β -hydroxylase is an enzyme that is localized to catecholamine-containing vesicles in sympathetic nerves and the adrenal medulla, and is also found in the serum. Treatment of rats with 6-hydroxydopamine, a drug which destroys sympathetic nerve terminals, leads to a decrease in serum dopamine-β -hydroxylase activity.

		Weinshilboum, Richard; Axelrod, Julius
Publication:		Science, Volume 173, Issue 4000, pp. 931-934
Publication Date:		09/1971
Origin:		JSTOR

Absence of the localized Schwartzman reaction

This investigation was undertaken to determine whether the presence of catechol amines was necessary for endotoxin to be operative in the production of a localized Schwartzman reaction. Seven rabbits were pretreated with 6–OH dopamine to produce a generalized chemical sympathectomy. An attempt was made to induce a localized Schwartzman reaction in these rabbits as well as in a control group. The rabbits in the experimental group did not develop the classical localized Schwartzman reaction, while those in the control group developed the localized Schwartzman reaction both clinically and histologically.
L. Shapiro ¹ , P. Cuevas ¹ , R. E. Stallard ¹ , M. P. Ruben ¹

¹ Clinical Research Center, Boston University Medical Center, School of Graduate Dentistry, Boston, Massachusetts, USA.

Journal of Periodontal Research, Volume 9 Issue 4, Pages 207 - 210

Published Online: 30 Jun 2006

Sympathectomy decreased NE and DA concentrations of muscles to approximately 10% of control values

We studied the effect of unilateral sympathectomy on rat quadriceps and gastrocnemius muscle concentrations of endogenous dihydroxyphenylalanine (DOPA), dopamine (DA), and norepinephrine (NE) and assessed the relationships between these catecholamines in several rat tissues. Catecholamines were measured by reverse-phase high-performance liquid chromatography with electrochemical detection. Sympathectomy decreased NE and DA concentrations of muscles to approximately 10% of control values, whereas the DOPA concentration tended to increase. Relatively high concentrations of DOPA were found in the gastrointestinal tract, kidney, and spleen. No correlations were obtained between the tissue concentration of DOPA and NE. A DA-to-NE ratio approximately 1% was observed in liver, muscle, pancreas, spleen, and heart, whereas we found exponentially increasing DA values with increasing NE concentration in tissues obtained from stomach, small and large intestine, kidney, and lung. In conclusion, endogenous DOPA in muscle tissue is not located in sympathetic nerve terminals but probably in muscle cells. DA concentrations in the gastrointestinal tract and in the kidneys were greater than could be ascribed to its role as a precursor in the biosynthesis of NE.

E. Eldrup, E. A. Richter and N. J. Christensen
Department of Internal Medicine and Endocrinology, Herlev University Hospital, Denmark.

Am J Physiol Endocrinol Metab 256: E284-E287, 1989;