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Technical considerations in endoscopic cervicothoracic sympathectomy

L G Josephs1, J O Menzoian

  • 1Section of Vascular Surgery, Center of Minimal Access Surgery, Department of General Surgery, Boston University School of Medicine, Mass, USA.

Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1996
PubMed
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Videoendoscopic cervicothoracic sympathectomy effectively treats upper extremity reflex sympathetic dystrophy and hyperhidrosis. This minimally invasive approach offers significant symptom relief with a low complication rate.

Area of Science:

  • Thoracic surgery
  • Minimally invasive procedures
  • Neuromodulation

Background:

  • Reflex sympathetic dystrophy (RSD) and hyperhidrosis significantly impact quality of life.
  • Traditional treatments for these conditions have limitations.
  • Videoendoscopic cervicothoracic sympathectomy presents a less invasive surgical option.

Purpose of the Study:

  • To evaluate the efficacy and safety of videoendoscopic cervicothoracic sympathectomy.
  • To assess the technique's outcomes in patients with upper extremity RSD or hyperhidrosis.
  • To analyze symptom relief and procedural complications.

Main Methods:

  • A clinical case series involving nine patients (seven with RSD, two with hyperhidrosis).
  • Ten videoendoscopic cervicothoracic sympathectomies were performed, targeting specific thoracic ganglia.

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  • Procedures involved general anesthesia and three small incisions, with intraoperative temperature monitoring.

    • Main Results:

    • The average operating time was 91 minutes, with a mean hospital stay of 3.5 days.
    • Nine out of ten patients experienced partial or complete symptom relief.
    • A mean increase of 2.4°C in skin temperature was observed; no cases of Horner's syndrome occurred.

    Conclusions:

    • Videoendoscopic cervicothoracic sympathectomy is a safe and effective minimally invasive treatment.
    • The procedure demonstrates significant success in alleviating symptoms of upper extremity RSD and hyperhidrosis.
    • This technique offers a valuable therapeutic option for selected patients.