The European journal of surgery = Acta chirurgica · 1997
Unilateral left-sided thoracoscopic sympathectomy for visceral pain control: a pilot study.
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Lönroth H, Hyltander A, Lundell L
Аннотация
OBJECTIVE: To examine the effect of unilateral left sided thoracoscopic denervation of the upper gastrointestinal tract for treatment of chronic pain.
DESIGN: Prospective study.
SETTING: University hospital, Sweden.
SUBJECTS: Patients with intractable upper abdominal pain. Nine patients were treated who had the following diagnosis: pancreatic carcinoma (4), duodenal carcinoma (n = 1), chronic pancreatitis (3), and portal vein thrombosis (n = 1).
INTERVENTIONS: Left-sided thoracoscopy with the patient anaesthetised using double-lumen endotracheal intubation that allowed ventilation of the right lung only. The sympathetic chain and splanchnic branches were divided from level IV to X-XI.
MAIN OUTCOME MEASURES: Severity of pain assessed by a visual analogue scale and mean consumption of analgesic drugs.
RESULTS: All patients reported substantial relief of pain postoperatively when they were studied during a mean follow-up period of 3 months. However, two patients (1 with pancreatic carcinoma and 1 with portal vein thrombosis) had recurrent pain after 3 months.
CONCLUSION: Unilateral thoracoscopic sympathectomy induces adequate and lasting relief of pain caused by benign as well as malignant diseases originating from the pancreatic region.
DESIGN: Prospective study.
SETTING: University hospital, Sweden.
SUBJECTS: Patients with intractable upper abdominal pain. Nine patients were treated who had the following diagnosis: pancreatic carcinoma (4), duodenal carcinoma (n = 1), chronic pancreatitis (3), and portal vein thrombosis (n = 1).
INTERVENTIONS: Left-sided thoracoscopy with the patient anaesthetised using double-lumen endotracheal intubation that allowed ventilation of the right lung only. The sympathetic chain and splanchnic branches were divided from level IV to X-XI.
MAIN OUTCOME MEASURES: Severity of pain assessed by a visual analogue scale and mean consumption of analgesic drugs.
RESULTS: All patients reported substantial relief of pain postoperatively when they were studied during a mean follow-up period of 3 months. However, two patients (1 with pancreatic carcinoma and 1 with portal vein thrombosis) had recurrent pain after 3 months.
CONCLUSION: Unilateral thoracoscopic sympathectomy induces adequate and lasting relief of pain caused by benign as well as malignant diseases originating from the pancreatic region.