Study designs of evaluations included in the review
Randomised controlled trials and prospective observational studies with at least 100 patients were eligible for inclusion in the review.
Specific interventions included in the review
Studies of ETS, which involves transection or clamping of the upper thoracic chain of the sympathetic nerve trunk, were eligible for inclusion. Details of the intervention varied between the included studies, but most involved transection at the T2 to T3 or T2 to T4 level. All the interventions were carried out under a general anaesthetic.
Participants included in the review
Studies of patients with facial blushing or excessive sweating on the face, hands, trunk or feet were eligible for inclusion. Most studies were of patients with excessive sweating; only one included study recruited patients with facial flushing. The participants were typically young adults; the mean age (where reported) ranged from 21 to 34 years, although some studies included children and the overall age range was 5 to 72 years. The percentage of males ranged from 27 to 56%.
Outcomes assessed in the review
Studies were required to report at least one outcome measure related to sweating or blushing symptoms. Most included studies reported on compensatory excessive sweating and immediate adverse events.
How were decisions on the relevance of primary studies made?
Two reviewers together selected studies for the review.