Long-term pulmonary function after thoracic sympathectomy.
BACKGROUND
The purpose of this study was to evaluate the long-term and midterm effects of thoracic sympathectomy on pulmonary function and to assess the influence of the sympathetic nervous system on bronchomotor tone.


METHODS
Thirty-seven consecutive patients were diagnosed with primary hyperhidrosis requiring thoracic sympathectomy and were included in this study. Spirometry and methacholine challenge testing were performed before and 3 months after surgery. To assess the long-term effects of the intervention, another spirometric study was performed 1 year later.


RESULTS
Spirometry 3 months after surgery showed a significant decrease in the forced vital capacity (-5.2%), the forced expiratory volume in the first second (-6.1%), and the forced expiratory flow between 25% and 75% of vital capacity (-5.1%). Whereas methacholine challenge testing before surgery was positive in 3 subjects (2 of whom were asthmatic), it was positive in 6 patients after the procedure; differences were not statistically significant. After 12 months, forced vital capacity started recovering, and forced expiratory volume in the first second and forced expiratory flow rate 25% to 75% showed a sustained and significant reduction (-2.8% and -11.2%, respectively); however, patients remained asymptomatic.


CONCLUSIONS
We conclude that thoracic sympathectomy generates a mild, although significant, impairment of the bronchomotor tone, with no clinical consequences. These results suggest that the sympathetic nervous system is involved in pulmonary bronchomotor tone.
Ponce González
Miguel A
MA
Department of Pulmonary Medicine, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain. migp@arrakis.es
Julià Serdà
Gabriel
G
Santana Rodríguez
Norberto
N
Rodríguez Suárez
Pedro
P
Pérez Peñate
Gregorio
G
Freixinet Gilart
Jordi
J
Cabrera Navarro
Pedro
P
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012123:Pulmonary Ventilation; D013562:Sympathectomy; D013900:Thoracic Nerves / Q000601:surgery*; D013997:Time Factors