A 7-year experience with thoracoscopic sympathectomy for critical upper limb ischemia.
BACKGROUND
Severely symptomatic arterial insufficiency of an upper limb not suitable for revascularization is a difficult condition to manage. Thoracoscopic sympathectomy (TS) can be an effective procedure in this setting.


METHODS
Our experience with 18 consecutive thoracoscopic sympathectomy (TS) procedures over a period of 7 years has been reviewed. Indications, operative technique, complications, and outcome of surgery are analyzed.


RESULTS
We performed 18 TS procedures on 17 patients during this period. There were no deaths. One patient had intraoperative hemorrhage necessitating conversion to open thoracotomy. Mean postoperative hospital stay was 2.3 days. Follow-up ranged from 6 to 72 months. All patients demonstrated clinical benefit from the procedure.


CONCLUSIONS
Thoracoscopic sympathectomy is a useful option in patients with severely symptomatic hand and digital ischemia from occlusive small arterial disease like thromboangitis obliterans.
Lee
Arvind Dhas
AD
Department of General and Vascular Surgery Unit 2, Christian Medical College Hospital, Vellore, South India 632004. arvindlee@yahoo.com
Agarwal
Sunil
S
Sadhu
David
D
D000328:Adult; D050197:Atherosclerosis / Q000601:surgery; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy; D013919:Thromboangiitis Obliterans / Q000601:surgery