Cerfolio RJ, Bryant AS, Bass CS

Idioma: Ingles.
Referencias bibliográficas: 7
Paginas: 191-194
Archivo PDF: 41.54 Kb.

RESUMEN

Background: Video-assisted thoracoscopic (VATS) sympathectomy or sympathotomy has been used predominantly for hyperhidrosis, however we have also used it to increase blood flow to ischemic hands. Methods: We reviewed our experience with VATS sympathotomy using one small incision in patients who have non-vascularizable cold, painful or non-healing hand ulcers. Patients had already maximized their arterial inflow. Results: Seven patients (5 men) with ischemic hands underwent VATS sympathotomy. Indication for surgery was cold and painful hands in 4 patients, non-healing ulcers in 2 and pain from reflex sympathetic dystrophy in 1, additionally four patients also had Berger’s disease. The sympathetic chain was interrupted at the T2 level in 6 cases and at both T2 and T3 in one case. Hand temperature in the operating room raised a mean of 1.0°F and transcutaneous oxygen raised a mean of 4%. All patients were initially satisfied with the results however some pain returned in four out of the seven patients by six months. Conclusions: VATS sympathotomy increases the blood flow to an ischemic hand that has failed other vascular procedures. It decreased the pain of ischemia and reflex sympathectomy dystrophy, but some pain seems to return after several months in selected patients.

REFERENCIAS (EN ESTE ARTÍCULO)

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