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Endoscopic thoracic sympathectomy (ETS) is a surgical procedure in which a portion of the sympathetic nerve trunk in the thoracic region is destroyed. [1] [2] ETS is used to treat excessive sweating in certain parts of the body (focal hyperhidrosis), facial flushing, Raynaud's disease and reflex sympathetic dystrophy.
Hyperhidrosis is a medical condition in which a person exhibits excessive sweating, [1] [2] more than is required for the regulation of body temperature. [3] Although it is primarily a physical burden, hyperhidrosis can deteriorate the quality of life of the people who are affected from a psychological, emotional, and social perspective. [4]
Compensatory hyperhidrosis; Following Endoscopic thoracic sympathectomy surgery for axillary (armpit), palmar (palm) hyperhidrosis and blushing, the body may sweat excessively at untreated areas, most commonly the lower back and trunk, but can be spread over the total body surface below the level of the cut.
For scale, cutting administrative costs to peer country levels would represent roughly one-third to half the gap. A 2009 study from Price Waterhouse Coopers estimated $210 billion in savings from unnecessary billing and administrative costs, a figure that would be considerably higher in 2015 dollars. [50] Cost variation across hospital regions.
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For palmoplantar hyperhidrosis, 20% aluminum chloride hexahydrate in absolute anhydrous ethyl alcohol () is the most effective topical treatment. [4] Other topical treatments such as potassium permanganate, tannic acid (2 to 5 percent solutions), resorcinol, boric acid, formaldehyde, methenamine, and glutaraldehyde have yielded less than desirable results.
Harlequin syndrome can alternatively be the outcome of a one-sided endoscopic thoracic sympathectomy (ETS) or endoscopic sympathetic blockade (ESB) surgery. [ 2 ] [ 4 ] It can also be observed as a complication of veno-arterial extracorporeal membrane oxygenation (ECMO).
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