[Evaluation of surgical therapy for thromboangitis obliterans, with special reference to follow-up studies]

Out of sixty patients with thromboangitis obliterans from January 1966 to December 1981, 50 cases underwent such surgery as sympathetic ganglionectomy, thromboendarterectomy and arterial bypass. The remaining 10 cases received conservative therapies such as intravenous infusion of Prostaglandin E1 (60 micrograms in 5% glucose 500 ml) and epidural sympathetic ganglion block using 1% xylocaine. Good results were obtained in 29 operative cases and in 5 cases with non-surgical therapies. Among the operative cases, the subjective symptoms after discharge improved in forty-one patients (82%) unchanged in three (6%) and remained poor in six (12%). While, those of non-surgical group improved in eight and unchanged in two. In twelve of twenty-nine operative patients whose subjective symptoms improved immediately after discharge, their subjective distress turned worse again. However, the subjective symptoms of 5 patients in non-surgical group remained well in follow-up studies. Many patients who were diagnosed unchanged during follow-up period, had underwent the lumbar and/or thoracic sympathetic gangloinectomy. It is thus concluded that the effects of the sympathetic ganglionectomy are not permanent. The arterial reconstructive surgery is very effective for relief of peripheral ischemia in the follow-up studies if good function of the grafts was obtained in the early postoperative period.