Vascular surgery: thoracoscopic sympathectomy: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Vascular surgery: thoracoscopic sympathectomy

Sample item

A 20-year-old with severe palmar hyperhidrosis undergoes thoracoscopic sympathectomy at the T2 and T3 levels. Which is the most common troublesome late complication?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Compensatory sweating of the trunk

Sympathectomy cures palmar sweating in most patients, but compensatory hyperhidrosis of the trunk, back and thighs is the commonest late problem and can be severe. Horner syndrome and pneumothorax are recognised but uncommon early complications.

Option by option

  • A. Gustatory sweating

    Gustatory sweating occurs after parotid surgery as Frey syndrome and not after thoracic sympathectomy.

  • B. Pneumothorax requiring a chest drain

    Pneumothorax is an early complication that is usually minor and resolves.

  • C. Horner syndrome

    Horner syndrome from stellate ganglion injury is uncommon with careful T2 and T3 level surgery.

  • D. Compensatory sweating of the trunk (correct)

    Correct. Compensatory truncal sweating is the commonest late complication.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Compensatory sweating of the trunk. Sympathectomy cures palmar sweating in most patients, but compensatory hyperhidrosis of the trunk, back and thighs is the commonest late problem and can be severe.

Why is "Gustatory sweating" not the answer?

Gustatory sweating occurs after parotid surgery as Frey syndrome and not after thoracic sympathectomy.

Why is "Pneumothorax requiring a chest drain" not the answer?

Pneumothorax is an early complication that is usually minor and resolves.

Why is "Horner syndrome" not the answer?

Horner syndrome from stellate ganglion injury is uncommon with careful T2 and T3 level surgery.

What concept does this question test?

It tests Vascular surgery: thoracoscopic sympathectomy in General Surgery. Horner syndrome and pneumothorax are recognised but uncommon early complications.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vascular surgery: thoracoscopic sympathectomy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.