For those who want to take ETS surgery

This article is a translation of an article written in December 2016.

▶ Japanese

I heard from the person who had ETS surgery that he consulted my blog prior to the surgery.
I think that the mind and method about ETS surgery has changed from the time I received it to the present.
So I'm not sure if everything is true, but I think I will write a message to anyone who would like to take ETS surgery.

I am negative about ETS surgery.
It is not reasonable at all for a person who has had reversal surgery to recommend ETS surgery. Therefore, I always say strongly that you shouldn't do it.
Still, there are people who want to undergo it.
This is the minimum advice to those people.


What you should try before taking ETS surgery
Aluminum chloride and Iontophoresis should definitely be tried before ETS surgery. If this works, you don't have to take the surgery.
You can also use Pro-Banthine (Generic: Prospas). Many people use it for compensatory sweating, so it should work on hand and foot sweats. If you want to stop your sweat only when important, I think that you might use such a drug. Some people say that just holding it as an amulet is effective.


Nerve burned out by ETS surgery
The nerves are burn out like this. (This is an overseas video excising T2 / T3 / T4)

ETS Surgery (Endoscopic Thoracic Sympathectomy)

Burnt nerves can no longer be undone.
Some people said "I didn't know it was like this. If I saw this in advance, I didn't undergo the surgery."


Excision position of ETS surgery
The resection place where all doctors have a consensus does not seem to be established, but commonly, that for hand sweat is referred to as T2 and T3. Though T4 becomes a candidate for underarm sweat, I heard from Dr. Shiotani that T4 alone won't stop hand sweat. Since T2 has strong compensatory sweating, I think that excising T3 may be the optimal solution.
However, there seems to be no method to confirm the excision site by X-ray or the like.


Compensatory sweating
Compensatory sweating occurs 100% when taking ETS surgery.
Satisfaction is a criterion for accepting compensatory sweating while hand sweat is gone, and is a personal judgment. Since the satisfaction rate published by hospital incorporates the hospital's intention, I'm not sure whether the overall patient satisfaction is reflected correctly.
Also, compensatory sweating may worsen over the years.


Are you satisfied with the one-sided cutoff?
This is a big problem.
I think that the dominant hand is selected first in the case one-sided cutoff, but then the extent of compensatory sweating is low so likely to be satisfaction. (Of course, some people were disappointed with even only one-sided, some of whom took reversal surgery.)

If you cut off on one side, you may have another problem such as left / right difference in sweat on your face. You may want to stop sweat with both hands.

However, I think it will happen if you cut off on both sides.

I think this is why even if compensatory sweating is not too much of a concern on one-side, it can be fatal on both sides.


What is the deadly aftereffects of ETS surgery?
Intense compensatory sweating limits your summer outings.
Clothes can only be selected depending on how sweat is inconspicuous, and you are desperate for odor control.
You cannot eat spicy food in public because of gustatory sweating.
Your head is hot in summer, your hands is cold in winter.
You lose your energy, lower motivation, and change your emotions.


Is it true that it will not look like it used to be?
There used to be a time when cutting all of T2 / T3 / T4. By comparison, it may be true that it is not what it used to be. However, unbearable amounts of compensatory sweating have also occurred in people who have taken ETS surgery in recent years. Some people with bilateral T3 resection go to Finland for reversal surgery .


If disappointed at ETS surgery, then can I say that I have reversal surgery?
No, I can affirm.
If you took it in Finland, it will cost over 1.5 million yen. There is a risk that it will not work and recovery will take time. Even now, 15 years later, I'm still recovering.


ETS surgeon I recommend (in Japan)
So, though I strongly insisted that you should not took ets surgery, if you still want to take it, I recommend the "Japanese Society of Thoracoscopic Sympathetic Surgery", which studies ETS surgery seriously.

There is also a link to this group in my link collection (in the right column), and their hospitals from north Hokkaido to south Kyusyu were introduced on the site.

---

Back to English articles