title: Guidelines on surgery of the thoracic sympathetic nervous system.
abstract: Thoracic sympathetic nervous system (TSNS) surgery has increased in importance in the last few years, generating great expectations among the general population and the scientific community. This has been due to the excellent results obtained by videothoracoscopy-assisted thoracic sympathectomy in the treatment of essential hyperhidrosis and other TSNS disorders. This minimally invasive surgical technique has been shown to be effective, and with a low morbidity it is accepted as one of the best therapeutic options for the treatment of palmar and bilateral axillary hyperhidrosis and the number of patients consulting with the intention of having the operation has increased considerably. Although compensatory sweating, which is occasionally intense, often occurs after the surgery, this and other secondary effects of the technique are well tolerated by patients. The current evidence on TSNS and the treatment of essential hyperhidrosis is based on observational studies, making it difficult to compare series and draw conclusions. There has been much discussion on standardising the technique, defining the most favourable levels for clipping, and choosing the type of denervation with least secondary effects. This has led to the need to draw up these guidelines which should clarify and standardise the criteria for managing patients with disorders of TSNS.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario de La Princesa, Madrid, Spain. rmoreno@separ.es
authors.forename: Ramón
authors.initials: R
authors.lastname: Moreno Balsalobre
authors.forename: Nicolás
authors.initials: N
authors.lastname: Moreno Mata
authors.forename: Ricard
authors.initials: R
authors.lastname: Ramos Izquierdo
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Aragón Valverde
authors.forename: Laureano
authors.initials: L
authors.lastname: Molins López-Rodo
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rivas de Andrés
authors.forename: José Luis
authors.initials: JL
authors.lastname: García Fernández
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Cañizares Carretero
authors.forename: Miguel
authors.initials: M
authors.lastname: Congregado Loscertales
authors.forename: Miguel
authors.initials: M
authors.lastname: Carbajo Carbajo
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000601:surgery*; D006801:Humans; D006945:Hyperhidrosis / Q000628:therapy; D019635:Neurosurgical Procedures / Q000379:methods; D013564:Sympathetic Nervous System / Q000601:surgery*; D013909:Thorax