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- Title
Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique.
- Authors
Roon, Anniek M van; Kuijpers, Michiel; Zande, Saskia C van de; Abdulle, Amaal Eman; Roon, Arie M van; Bos, Reinhard; Bouma, Wobbe; Klinkenberg, Theo J; Bootsma, Hendrika; DeJongste, Mike J L; Mariani, Massimo A; Smit, Andries J; Mulder, Douwe J
- Abstract
Objective To assess the minimally invasive single-port thoracoscopic sympathicotomy feasibility and efficacy in patients with treatment-resistant RP. Methods Single-port thoracoscopic sympathicotomy was performed unilaterally on the left side in eight patients with RP (six males, two females, with a median age of 45.2 years). Five patients had primary and three had secondary RP. Perfusion effects in the hands were assessed at baseline and after 1 month by using a cooling and recovery procedure, and by using laser speckle contrast analysis. Number and duration of RP attacks were reported over a 2-week period. Results Patient satisfaction was 100% after surgery. After surgery, a unilateral improvement in perfusion was observed in the left hand compared with the right hand, with cooling and recovery (P = 0.008) and with laser speckle contrast analysis (P = 0.023). In addition, the number and duration of the attacks in the left hand decreased compared with the right hand (both P = 0.028). No serious adverse events occurred in a follow-up period of at least 10 months. Conclusion Single-port thoracoscopic sympathicotomy is feasible and can be effective in improving hand perfusion in patients with RP. However, long-term efficacy needs to be established. Clinical trial registration number NCT02680509.
- Subjects
CLINICAL trials; COMPARATIVE studies; ENDOSCOPIC surgery; HAND; PATIENT satisfaction; PATIENTS; PERFUSION; RAYNAUD'S disease; SURGERY; SYMPATHECTOMY; PILOT projects; TREATMENT effectiveness; DESCRIPTIVE statistics; VIDEO-assisted thoracic surgery; EVALUATION
- Publication
Rheumatology, 2020, Vol 59, Issue 5, p1021
- ISSN
1462-0324
- Publication type
Article
- DOI
10.1093/rheumatology/kez386