the heart obeys Starling's law after chemical sympathectomy

This can be seen most dramatically in the case of premature ventricular contraction. The premature ventricular contraction causes early emptying of the left ventricle (LV) into the aorta. Since the next ventricular contraction will come at its regular time, the filling time for the LV increases, causing an increased LV end-diastolic volume. Because of the Frank-Starling law, the next ventricular contraction will be more forceful, causing the ejection of the larger than normal volume of blood, and bringing the LV end-systolic volume back to baseline.

The more the myocardium is dilated, the weaker it can pump, as it then reverts to Laplace's law.
http://en.wikipedia.org/wiki/Frank-Starling_law_of_the_heart

Response to adrenaline after sympathectomy

None of the hands in this series
exhibited significant change in flow with A1 ,ug/min. With A ,ug/min, however,
eight of the thirteen hands now had 25 % or more vasoconstriction, the mean
for the group being 30 %. With i p,g no less than eight of the ten hands tested
had more than 25 % vasoconstriction.
Thus for the two groups receiving H and i ug adrenaline marked increases
in the mean responses from 11 to 30 % and from 16 to 44 %, respectively, were
observed after sympathectomy. The ratio of postoperative to preoperative
mean responses was about the same for both doses (2-7 and 2-8). The increased
response after sympathectomy is seen (Table 2) to be due especially to changes
in hands 3, 6, 9, 11, 12 and 13, which before operation had minimal constric-
tions but responded with marked reductions in blood flow after sympathectomy.
The altered behaviour of two of these hands is portrayed in Figs. 1 and 2.
Although some of the other seven hands also showed increased vasoconstric-
tion with a given dose of adrenaline after sympathectomy this increase was
less notable.
The paired differences between the hands before and after sympathectomy
are significant at the A .g/min (t = 3-03, P < 0-02), and the i ,ug/min (t = 3-55,
P < 0-01) levels. Of the six hands manifesting notable increases in sensitivity
to adrenaline three were sympathectomized by preganglionic section and three
by ganglionectomy.
J. Physiol. (I955) I29, 53-64
EFFECT OF ADRENALINE AND NORADRENALINE ON
BLOOD VESSELS OF THE HAND BEFORE AND AFTER
SYMPATHECTOMY
BY R. S. DUFF
From the Cardiological Department, St Bartholomew's Hospital and the
Sherrington School of Physiology, St Thomas's Hospital, London

Sympathectomy and fraud

HUGE BILL FRAUD CITED AT CLINICS

March 12, 2005 - By ROBERT PEAR - National Desk - 933 Words

Twelve Blue Cross and Blue Shield plans, working with the F.B.I., said Friday that they had broken up an elaborate insurance scheme in which thousands of patients from 47 states were sent to California to undergo unnecessary surgical and diagnostic procedures, for which doctors filed more than $1 billion of fraudulent insurance claims. Insurance executives and law enforcement officials said that surgery clinics in Southern California typically paid recruiters $2,000 to $4,000 for each patient who received a medical procedure. The patients, they said, received rewards in the form of cash or discounts on cosmetic surgery.

potential complications of hemorrhage, arrythmia, hypotension, pneumothorax, pain, persistent air leak

Thorascopic manipulation of the lung and mediastinal structures may result in cardiac arrhythmias. Electrical current from the cautery may initiate atrial or ventricular tachycardia or fibrillation. Sinus tachycardia may occur secondary to CO2 retention when insufflation techniques are used. A mediastinal shift with compromise of venous return to the heart may initiate a reflex sinus tachycardia. Vagal stimulation and air or CO2 embolism with insufflation techniques may lead to bradycardia or asystole. Hypotension may result from mediastinal tamponade, air or CO2 embolization, or hemorrhage. Hypercarbia, which results from CO2 insufflation, can result in hypertension and tacjycardia. Hemorrhage from the intracostal vessels may occur at the site of trocar placement.
Exposure of the thoracic sympathetic chain requires retraction of the lung apex away from the posterior chest wall. Improper instrumentation and the frequent presence of apical blebs or adhesions may result in a parenchymal lung injury and postoperative pneumothorax or persistent air leak.

The operative procedure and the potential complications of hemorrhage, arrythmia, hypotension, pneumothorax, pain, persistent air leak, inability to complete the procedure thoracoscopically, and death are reviewed with the patient.

Haimovici's Vascular Surgery

Edition: 5, illustrated

Published by Blackwell Publishing, 2004

Death following Sympathectomy

Maura Derrane: Tragedy of the man who died of shyness
Sunday Mirror, Dec 4, 2005 by Maura Derrane

THE wife of a solicitor who died two days after undergoing an operation to stop blushing was paid nearly EUR5million in compensation during the week.

Eleanor Synnott sued the surgeon and the hospital where the operation took place. The award was one of the biggest ever paid out in Ireland.

Alan Synnott was one of the country's most successful personal injuries solicitors.
Court papers revealed that there were problems inserting the tubular device into his chest and that as a result of this his lungs were damaged and massive bleeding occurred.

Although emergency surgery was performed Alan Synott never regained consciousness and died two days later.

In 70 % compensatory sweating severe

In T2 and T3 resection, all patients experienced Compensatory Sweating and over 70% of the patients felt it was severe. Even in T2 resection, 90% of patients experienced CS and in 50% of these it was severe. High rates of CS are reported in Asian countries with hot and humid climates.

In T2 resection, recurrence rates were 15% and 19% at 1 and 2 years after surgery.It was not rare for a patient to experience recurrence more than 3 years after surgery.
Motoki Yano, MD, PhD and Yoshitaka Fujii, MD, PhD

Volume 138, Issue 1, Pages 40-45 (July 2005)