[Percutaneous thoracic sympathectomy under x-ray computed tomographic control in hyperhidrosis and refractory ischemia. Apropos of 17 cases].
We report our experience with percutaneous thoracic sympathectomy using computed tomography-guided injection of phenol in 17 patients. A total of 24 neurolyses were performed in outpatients. Indications were palmo-plantar hyperhidrosis in 10 patients and severe Raynaud phenomena in 7 cases (Sharp's syndrome = 2. sclerodermia = 3, Raynaud's syndrome = 1, digital arteritis = 1). Conventional treatment had failed in all patients. Cure was obtained in all cases of hyperhidrosis. For the patients with critical ischemia, there was temporary improvement which allowed wound healing, but recurrence was the rule within 6 months on average. Complications included pneumothorax, brachial nevralgia which persisted for 4 months and 3 partial Claude-Bernard-Horner syndromes. This technique is an inexpensive reliable method which can be used in case of contraindications or to avoid certain complications of endoscopic surgery which remains the standard treatment. Percutaneous sympatholysis in thus an interesting simple alternative.
Wazières
B D
BD
Service de Médecine Interne, Hôpital Jean-Minjoz, Besançon.
Bartholomot
B
B
Fest
T
T
Combes
J
J
Kastler
B
B
Dupond
J L
JL
D000293:Adolescent; D000328:Adult; D005121:Extremities / Q000098:blood supply; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000000981:diagnostic imaging / Q000628:therapy*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D010636:Phenols; D011928:Raynaud Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D013563:Sympathectomy, Chemical; D013904:Thoracic Vertebrae; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D010636:Phenols