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| Min-Huei Hsu Department of Neurourgery, Taipei City Hospital, Zhongxiao Branch Send letter to journal: Email Min-Huei Hsu
| Endoscopic thoracic sympathectomy (ETS) has come into widespread use for palmar hyperhidrosis. Side sffects after ETS was widely discussed in Taiwan society in the past few months. Lots of people in Taiwan suffer from hyperhidrosis palmaris. ETS is covered by the National Health Insurance, and patient billing for this operation does not exceed US$ 60. This is why this operation is so popular here 1 . Patients with severe compensatory sweating after ETS must change clothes several times a day (some patients complained that they change as often as 10 times a day), resulting in serious impact on work and social interaction. Patients suffering from such serious side effects in Taiwan have formed a support group based on an Internet discussion forum to request the government to take this problem seriously. Starting in October 2004, The Department of Health, Executive Yuan, Taiwan, has prohibited surgeons from performing this operation on patients under 20 years old. To our knowledge, this type of support group also exists in United States, England, Sweden, Spain and Japan (Table 1). ETS is a relatively safe and simple procedure. However the side effects are possibly devastating 2 . All physicians providing this service and all peoples preparing to undergo this treatment should know this well. | |||
"Sympathectomy is a technique about which we have limited knowledge, applied to disorders about which we have little understanding." Associate Professor Robert Boas, Faculty of Pain Medicine of the Australasian College of Anaesthetists and the Royal College of Anaesthetists, The Journal of Pain, Vol 1, No 4 (Winter), 2000: pp 258-260