28 patients underwent sympathectomy and 29 underwent sympathotomy. In both groups we found increased vagal activity and a significant decrease in adrenergic activity through reduced heart rate. These alterations were more evident in the group that underwent sympathectomy.

Endoscopic thoracic sympathectomy caused a shift of sympathovagal balance toward para-sympathetic tone that seems to be associated with the extent of denervation


21 patients in each group (sympathectomy and sympathotomy) completed the study. In the group that underwent sympathotomy, no significant cardiac alterations were found, in the group that underwent sympathectomy, there was a significant reduction in heart rate at rest and in exercise. These changes remained after 6 months of the procedure.

Sympathectomy may result in a disturbance of bronchomotor tone and cardiac function. Such changes remained at a sub-clinical level and seemed directly correlated with the extension of denervation.


Pulmonary function tests show a significant reduction in FF1, FeF 25% - 75% of vital capacity in both groups. Heart rate at rest and after maxima exercise also decreased significantly in both groups. Despite all the alterations, the patients remained asymptomatic. We did not find differences between the sympathectomy and sympathotomy groups.

Simplified and conventional thoracic sympathectomy resulted in a long-term reduction in FEV1, FEF25% - 75%, DLCO, and resting and maximal heart rate, as well as a mild but significant increase in airway resistance in the conventional thoracic sympathectomy group, without any clinical consequence to the patient. These changes were unrelated to the level of transection of the thoracic sympathetic chain.