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Transthoracic endoscopy for upper thoracic chemical sympathectomy
E Bardaxoglou1, B Reigner, B Enon
1Service de Chirurgie Vasculaire et Thoracique, Centre Hospitalier et Universitaire, Angers, France.
Annals of Vascular Surgery
|July 1, 1992
Summary
Transthoracic endoscopic chemical sympathectomy offers a simple, minimally invasive option for treating arterial disease and hyperhidrosis. This technique provides a valuable alternative to traditional surgery with a short hospital stay.
Area of Science:
- Thoracic surgery
- Minimally invasive procedures
- Neuromodulation
Background:
- Occlusive arterial disease, Raynaud's syndrome, and palmar hyperhidrosis are conditions that can significantly impact quality of life.
- Conventional surgical sympathectomy carries risks and requires longer recovery periods.
- Endoscopic techniques offer potential for less invasive interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of upper thoracic chemical sympathectomy using transthoracic endoscopy.
- To assess this technique as an alternative to conventional surgical sympathectomy.
Main Methods:
- Eight patients underwent upper thoracic chemical sympathectomy via transthoracic endoscopy.
- Indications included occlusive arterial disease (4 patients), Raynaud's syndrome (2 patients), and palmar hyperhidrosis (2 patients).
- Phenol was injected into the parietal pleura covering proximal thoracic ganglia under general anesthesia.
Main Results:
- No initial failures were reported in the eight patients.
- Postoperative course was largely uneventful, with one instance of subcutaneous emphysema.
- Transient Horner's syndrome occurred in three patients.
Conclusions:
- Chemical sympathectomy via transthoracic endoscopy is a simple and effective alternative to conventional surgery.
- The procedure is associated with a short hospitalization period.
- Contraindications include pre-existing pleuropulmonary disorders.