Endoscopic thoracic sympathicotomy for Raynaud's phenomenon

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Vascular Surgery

Background:

• Open surgical sympathectomy for Raynaud's phenomenon had poor long-term outcomes.
• Endoscopic thoracic sympathicotomy (ETS) emerged as a less invasive surgical option.
• ETS aims to improve the efficacy and applicability of sympathectomy.

Purpose of the Study:

• To reevaluate the efficacy of endoscopic thoracic sympathicotomy (ETS) for Raynaud's phenomenon.
• To assess the range of applicability for ETS in treating Raynaud's phenomenon.
• To determine the safety and effectiveness of ETS in a clinical setting.

Main Methods:

• Endoscopic thoracic sympathicotomy (ETS) was performed on 28 patients with Raynaud's phenomenon between 1992 and 2001.
• Indications included severe symptoms or nonhealing digital ulcers refractory to medical therapy.
• Patient outcomes were assessed via a self-administered questionnaire for immediate and long-term results.

Main Results:

• Initial symptom resolution or improvement was observed in 92.9% of patients (26/28).
• Symptom recurrence occurred in 82.1% of patients (23/28) postoperatively.
• Overall improvement in symptom frequency and severity was reported by 89.3% (25/28) at long-term follow-up.

Conclusions:

• ETS provides significant initial relief and promotes healing of digital ulcers in Raynaud's phenomenon.
• Despite a high recurrence rate, ETS demonstrates potential for reducing symptom severity.
• ETS is considered a safe and effective treatment of choice for severe or refractory Raynaud's phenomenon, particularly with digital ulcers.