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Thoracoscopic sympathectomy for upper limb ischemic disease.

Al Grigorovici1, V Gavrilovici, R Popa

  • 1School of Medicine, 3rd Surgical Unit, University of Medicine and Pharmacy Gr.T. Popa, Iaşi.

Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi
|February 21, 2004
PubMed
Summary

Thoracoscopic sympathectomy effectively treated upper limb ischemic disease in two patients. This surgical approach relieved chronic pain and improved circulation, offering a viable treatment for severe cases.

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Area of Science:

  • Vascular Surgery
  • Thoracic Surgery
  • Neurology

Background:

  • Upper limb ischemic disease presents challenges in pain management and tissue viability.
  • Medical treatments often fail for advanced cases, necessitating surgical intervention.
  • Resectional thoracoscopic sympathectomy targets sympathetic nerve ganglia influencing vascular tone.

Observation:

  • Two patients with severe upper limb ischemia, chronic pain, cyanosis, and digital amputations were treated.
  • Previous medical management yielded no positive outcomes.
  • The surgical technique involved T2 and T3 thoracic ganglion resection via thoracoscopy.

Findings:

  • One patient underwent bilateral sympathectomy in two stages; the other had unilateral right-sided surgery.

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  • Both patients experienced uncomplicated postoperative recovery.
  • Immediate and short-term results demonstrated significant improvement in limb ischemia symptoms.

    • Implications:

    • Resectional thoracoscopic sympathectomy is a promising surgical option for refractory upper limb ischemia.
    • This minimally invasive technique can lead to favorable clinical outcomes.
    • Further research could explore long-term efficacy and patient selection criteria.