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J Thorac Cardiovasc Surg 2005;129:1379-1382
© 2005 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Long-term pulmonary function after thoracic sympathectomy

^a Department of Pulmonary Medicine, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain
^b Department of Thoracic Surgery, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain

Received for publication July 3, 2004; accepted for publication August 23, 2004.

^_* Address for reprints: Miguel A. Ponce González, MD, Department of Pulmonary Medicine, Hospital Universitario de Gran Canaria Dr Negrín, C/ Barranco de la Ballena s/n, 35020, Las Palmas de Gran Canaria, Spain (Email: migp{at}arrakis.es).

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.

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