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Intraoperative cardiac arrest: a rare complication of T2,3-sympathicotomy for treatment of hyperhidrosis palmaris. Two case reports.

Endoscopic surgery, including thoracoscopic sympathicotomy for treatment of hyperhidrosis, is thought to be safe and entail fewer complications as compared with open methods. A total of more than 719 patients with hyperhidrosis have undergone thoracoscopic T2,3-sympathicotomy for treatment of hyperhidrosis at Tainan Municipal Hospital since October 1, 1989. Most of the complications have been minor; however, two of the patients suffered from sudden cardiac arrest at the time when the left T2,3-sympathetic nerve trunk was transected by the thoracoscopic method. Vigorous cardiopulmonary resuscitation was performed and both patients recovered completely without any sequelae. The purpose of this paper was to discuss the possible mechanism of cardiac arrest in thoracoscopic sympathicotomy, and to emphasise this rare but potentially fatal complication in the treatment of hyperhidrosis palmaris.