Thoracic sympathectomy as a therapy for upper extremity ischemia. A long-term follow-up study

Fifty-seven patients who had 72 thoracic sympathectomies have been reviewed. Twenty-five patients were preoperatively diagnosed as having primary Raynaud's phenomenon, 14 as having Raynaud's phenomenon secondary to arterial occlusion, 17 as having ischemia secondary to arterial occlusion and one as having hyperhidrosis. Twenty percent of the patients initially diagnosed as having primary Raynaud's phenomenon at the time of operation developed a collagenosis during the follow-up period. Improvement after 8 years' follow-up did not depend on the primary indication. Up to the fifth year after surgery a relapse was seen in cases of primary Raynaud's phenomenon. In secondary Raynaud's phenomenon a gradual decrease in improvement of 2% a year was seen during follow-up. In ischemia secondary to arterial occlusion, after 2 years the percentage of improved patients remained constant at a level of 70%. The mean improvement after 8 years follow-up according to the survival test of Gehan was 70 +/- 10%.