Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique. (16th September 2019)

• Record Type: Journal Article
• Authors: van Roon, Anniek M; Kuijpers, Michiel; van de Zande, Saskia C; Abdulle, Amaal Eman; van Roon, Arie M; Bos, Reinhard; Bouma, Wobbe; Klinkenberg, Theo J; Bootsma, Hendrika; DeJongste, Mike J L; Mariani, Massimo A; Smit, Andries J; Mulder, Douwe J
• Is Part Of: Rheumatology. Volume 59:Number 5(2020)
• Page Start: 1021
• Page End: 1025
• Publication Date: 2019-09-16
• Subjects: Raynaud's phenomenon -- sympathicotomy -- blood perfusion -- laser speckle contrast analysis; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/kez386
• Languages: English
• ISSNs: 1462-0324

Abstract

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.