The amount of compensatory sweating depends on the patient, the damage that the white rami communicans incurs, and the amount of cell body reorganization in the spinal cord after surgery.
Other potential complications include inadequate resection of the ganglia, gustatory sweating, pneumothorax, cardiac dysfunction, post-operative pain, and finally Horner’s syndrome secondary to resection of the stellate ganglion.
www.ubcmj.com/pdf/ubcmj_2_1_2010_24-29.pdf

After severing the cervical sympathetic trunk, the cells of the cervical sympathetic ganglion undergo transneuronic degeneration
After severing the sympathetic trunk, the cells of its origin undergo complete disintegration within a year.
http://onlinelibrary.wiley.com/doi/10.1111/j.1439-0442.1967.tb00255.x/abstract

Sunday, January 11, 2009

Impaired healing after sympathectomy

"The effect of neuropathy on healing of the medial collateral ligament was studied in rats that
had undergone surgical sympathectomy (autonomic neuropathy) or femoral nerve transaction (sensory neuropathy)40. There were significant decreases in various neuropeptides, such as substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide, in the denervated tissues. Impaired healing, demonstrated by significant decreases in failure force of the healing ligaments, was seen in both groups of rats."

Effect of cervical vagosympathectomy on myocardial catecholamine concentration

Dogs which survived a bilateral cervical vagosympathectomy showed a striking reduction in catecholamine concentration of right atrial tissue. Significant decreases in catecholamine concentration were noted also in the tissues of both ventricles and the interventricular septum. Unilateral cervical vagosympathectomy, either right or left, was not followed by a statistically significant decrease in the concentration of cardiac catecholamines. The cause of the depletion after bilateral cervical vagosympathectomy is not clear. It may be due to destruction of intracardiac adrenergic nerves or a relatively increased utilization of catecholamines, which exceeds the capacity of the cardiac tissues to synthesize, take up, or bind these substances.
Am J Physiol 209: 951-954, 1965;

Bradycardia and Permanent Pacing After Bilateral Thoracoscopic T2-Sympathectomy for Primary Hyperhidrosis

LAI, C.-L., et al.: A 23-year-old woman with craniofacial hyperhidrosis underwent bilateral thoracoscopic T2-sympathectomy. Marked sinus bradycardia with a mean heart rate of 49 beats/min by Holter ECG monitoring occurred after the procedure and persisted for > 2 years. Normal sinus node function was found by an invasive electrophysiological study and unopposed vagotonia after sympathectomy was diagnosed. A permanent pacemaker was implanted. Although reduced heart rate is a common phenomenon after bilateral dorsal sympathectomy, intractable bradycardia with permanent pacing is rare. This patient demonstrates one of the potential cardiac complications of bilateral sympathectomy.

http://www3.interscience.wiley.com/journal/119020027/abstract

orthostatic hypotension secondary to lumbar sympathectomy

Treatment of a 55-year-old woman with Raynaud's phenomenon and orthostatic hypotension secondary to lumbar sympathectomy performed for Raynaud's phenomenon is described.
Kochar MS.
Am J Med. 1983 Sep;75(3):537-40.

Acute cardiogenic shock after lumbar sympathectomy by phenol injection


Bulpa PA, De Wispelaere JF, Dive A, Haufroid V, Installé E.

Department of Intensive Care, Mont-Godinne University Hospital, Université Catholique de Louvain

Intensive Care Med. 2002 Jan;28(1):92-3. Epub 2001 Nov 23.

Subscribe to: Posts (Atom)