Article révisé par les pairs
Résumé : The purpose of this paper is to define the nature and the frequency of post lumbar sympathectomy complications and to reappreciate their importance in the evaluation of operative indication. The non specific miscellaneous complications are no more frequent than after any other lumbotomy. The specific complications occur in less than 10%; they are almost always transient. Prolonged paralytic ileus is related to postoperative hematoma in the retroperitoneal space. Ejaculation disturbances are produced either by bilateral resection of one of the two first lumbar ganglia or by section of the intermesenteric plexus, the presacral nerves or the hypogastric nerves during associated dissection of the aortic bifurcation. Late neuralgia is probably induced by retroperitoneal hematoma; its size increases gradually during the postoperative period by transference of tissue fluids. In conclusion, the mortality and the morbidity rates of lumbar sympathectomy are remarkably low; these are not arguments against the lumbar sympathectomy.