M.Hashmonai
D.Kopelman
The pathophysiology of cervical
and upper thoracic sympathetic surgery
The main effect of upper thoracic sympathectomy is su-
domotor.To abolish sweating ofthe
palms,T2ganglionectomy
with the addition ofT3) was invari-
ably performed.To prevent axillary
sweating,additional T4ablation
was recommended.Sympathec-
tomy produces a vasodilatatory cu-
taneous effect.The circulation in
the muscles,however,is unaltered
or may even be reduced.It also ap-
pears that improved skin blood
flow is on the thermoregulatory,
not nutritive level.It seems that
chronic surgical sympathectomy
does not cause major changes in
the vascular function ofthe fore-
arm.Although the exact patho-
physiological mechanism ofblush-
ing is still obscure,bilateral upper
dorsal sympathectomy alleviates
this phenomenon.T2-T3gan-
glionectomy significantly decreases
pulse rate and systolic blood pres-
sure,reduces myocardial oxygen
demand,increases left ventricular
ejection fraction and prolongs Q-T
interval.A certain loss oflung vol-
ume and decrease ofpulmonary
diffusion capacity for CO result
from sympathectomy.Histomor-
phological muscle changes and
neuro-histochemical and biochem-
ical effects have also been ob-
served.
Key words sympathectomy ·
sudomotor effect · circulatory
effect · cardiac effect ·
thermoregulation