Results of thoracolumbar sympathectomy for essential hypertension; three-to-seven-year follow-up of one hundred patients

The principal measures which are available for the treatment of patients with essential hypertension at the present time are (1) diets, especially those low in sodium; (2) drugs having a general sedative effect or a specific hypotensive effect, and (3) surgery of the sympathetic nervous system with or without resection of adrenal tissue. The first operative attempt to influence hypertension by resection of the abdominal sympathetic system is accredited to Pieri in 1930. He performed a resection of the greater splanchnic nerve. Adson and Brown in 1934 described intraspinal rhizotomy. Adson and Peet in 1935 described the procedures that are generally known by their names. Thoracolumbar sympathectomy was first performed by Smithwick, in 1938, and described by him in 1940. Green first attempted total bilateral adrenalectomy and reported the results in one case in 1950. 1 We recently have reported our experience with 126 patients subjected to combined sympathectomy-adrenalectomy. 2