Bilateral thoracoscopic splanchnicectomy with sympathectomy for managing abdominal pain in cancer patients.
BACKGROUND
Simple interruption of splanchnic nerve can lead to incomplete transection of nerve fibers responsible for cancer-derived abdominal visceral because lots of neural communications exist.


METHODS
From December 1999 to June 2005, a total of 21 cancer patients underwent bilateral thoracoscopic segmental resection of splanchnic nerve with sympathectomy for intractable abdominal pain based on the anatomic observation of 26 embalmed Korean cadaveric specimens in Yonsei University Medical Center, Seoul, Korea. All patients were preoperatively asked to rate the extent of their current pain by using the numeric rating scale (NRS), where 0 indicated no pain and 10 indicated intractable pain. The effectiveness of this thoracoscopic procedure was assessed based on the NRS reevaluated after surgery.


RESULTS
NRS score was significantly reduced after thoracoscopic surgery (1.71 +/- 1.10 versus 8.52 +/- 1.08, paired t test, P < .0001). Sixteen patients (76.2%) could tolerate pain without or with reduced dose of analgesics. No mortality and morbidity were found in this study.


CONCLUSIONS
This bilateral thoracoscopic splanchnicectomy with sympathectomy is safe, easy, and effective method in managing cancer-derived visceral abdominal pain.
Kang
Chang Moo
CM
Department of Surgery, Yonsei University College of Medicine, 250 Seongsanno (134 Shinchon-dong), Seodaemun-gu, Seoul, Korea, 120-752.
Lee
Hye Yeon
HY
Yang
Hee Jun
HJ
Jang
Han Jung
HJ
Gil
Young Chun
YC
Kim
Kyung Sik
KS
Choi
Jin Sub
JS
Lee
Woo Jung
WJ
Kim
Byong Ro
BR
D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery*; D000368:Aged; D002102:Cadaver; D004067:Digestive System Neoplasms / Q000150:complications*; D004210:Dissection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013153:Splanchnic Nerves / Q000601:surgery*; D013562:Sympathectomy / Q000379:methods*; D013906:Thoracoscopy; D016896:Treatment Outcome