What are the side effects of endoscopic thoracic sympathectomy (ETS)?

All patients undergoing endoscopic thoracic sympathectomy (ETS) will experience some compensatory sweating. This is unavoidable because in patients with hyperhidrosis the propensity to have excessive sweating cannot be eliminated. Surgery only eliminates the pathway to the sweat glands of the hand. In the majority of patients, compensatory sweating is mild, well-tolerated, and an acceptable alternative to severe palmar sweating.

Certain patients seem to experience worse compensatory sweating. Patients who experience excessive sweating over their entire body before ETS tend to have more severe compensatory sweating.

The surgical technique also may have an impact on both the frequency and severity of compensatory sweating. Some patients have predominantly hand sweating, while others may also experience severe facial sweating and blushing at the same time.

Gustatory sweating is a relatively rare side effect of sympathectomy. Patients who experience this will notice increased sweating when eating certain foods or from the smell of some foods.

The sympathetic autonomic nervous system has a role in regulating cardiac function.  Based on the clinical data that has been published to date, there is no evidence that ETS surgery has any negative impact on cardiac function or the ability to reach preoperative peak workloads.

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