NEGATIVE EFFECTS OF ETS / ETS-C
Tuesday, February 3, 2009
NEGATIVE EFFECTS OF ETS / ETS-C
After ETS, about 85% of patients will note that they seem to sweat more on the trunk and legs of the body than previously. For 75% of these people it is mild, about 5% find it moderate, and 2% have found it severe. Most feel that it is not a major problem, that it occurs during periods of excessive stress or exercise. Some find it excessive and annoying, but acceptable. A few others are significantly hampered by their CS but don’t want reversal.
Bleeding
Bleeding can occur from the port sites and also from the veins adjacent to the sympathetic chain. Special ports have been devised to prevent this problem, and surgical skill is required in dealing with the sympathetic chain to prevent any bleeding from the surrounding vessels.
Compensatory sweating (CS).
Horner’s Syndrome
This occurs if the T1 (stellate) ganglion is damaged at the time of surgery. It results them ptosis (drooping of the eyelid), myosis (constriction of the pupil) and exopthalmus (forward protrusion of the eye). Fortunately, this is a very uncommon complication by the thoracic approach, because the T1 ganglion is at or above the level of the first rib, outside the thoracic cavity, and is not easily damaged by this approach.
Intercostal neuralgia
This nerve pain can result from mild nerve damage during the operation, or as a result of insertion of one of the ports. It may affect the arm, torso, or skin in those areas. It is not a common occurrence, and usually subsides in 3-6 weeks.
Pneumothorax (persistent air leak from lung)
This would be a very unusual complication.
Gustatory Sweating (GS)
Increased sweating after eating certain foods has also been described, but is much more unusual, occurring in perhaps 3-5% of patients.
