Endoscopic thoracic sympathectomy (ETS) is a surgical procedure used to treat a variety of conditions characterized by overactivity of the sympathetic nerves. These conditions include hyperhidrosis (excessive sweating), facial blushing, Raynaud’s disease, and reflex sympathetic dystrophy. This article will focus specifically on ETS as a treatment for hyperhidrosis (excessive sweating), and in particular, the excessive sweating in child treatment.
Hyperhidrosis is a common condition affecting around 3% of the population and can be extremely distressing for the individual involved. It typically affects the hands, feet, and armpits, with the excessive sweating often severely impacting the individual’s quality of life. Specific child cases can be troublesome as excessive sweating can lead to social ridicule amongst peers resulting in psychological consequences.
Understanding Endoscopic Thoracic Sympathectomy
ETS is a minimally invasive surgical procedure performed to curb excessive sweating. During the operation, the surgeon locates and cuts, or clamps, the sympathetic nerves responsible for triggering sweating in the specific area. This is typically done through small incisions under the armpits, allowing the surgeon to reach the nerve chains along the spinal cord.
The Procedure
The surgical procedure is performed under general anesthesia. It typically requires two small incisions under each armpit. Through these incisions, the surgeon introduces a miniature camera (the endoscope) which gives a detailed view of the sympathetic nerve chains. Depending on the specific clinical requirements, the surgeon will either cut, clamp, or apply a form of energy, like electric currents, to the nerve portions causing hyperactivity, thus reducing or eliminating the symptoms of excessive sweating.
After an ETS procedure, most individuals have an immediate cessation of sweating in the treated region. Recovery time is generally swift due to the minimally invasive nature of the procedure. After a short period in the hospital for observation, patients will typically resume daily activities within a week.
Excessive Sweating in Child Treatment
When it comes to excessive sweating in child treatment, ETS may be considered if other treatments have failed or are not suitable. It is important to note that this is not a first-line treatment and is generally used only after exploring less invasive treatments like antiperspirants, iontophoresis, and medication.
While the ETS procedure can provide significant relief from symptoms, it also carries the risk of possible complications like compensatory sweating (increased sweating in other body parts), lung problems, Horner’s syndrome (drooping of the eyelid with decreased pupil size), and nerve damage.
Parents and caregivers must weigh the potential benefits with the risks when deciding on the suitability of ETS for a child. Critical to decision-making is an open and thorough discussion with healthcare professionals to understand the full implications of the procedure.
Conclusion
ETS offers hope for a long-term, if not permanent, solution for hyperhidrosis, including in children. This relatively quick and minimally invasive procedure can make a significant difference to a child’s quality of life. However, the decision to undergo surgery should only be made after careful consideration of the potential benefits and risks associated with the procedure.