Videothoracoscopic splanchnicectomy for intractable pain from adrenal metastasis.

Splanchnicectomy has been known for years as a treatment for refractory pain in patients with pancreatic cancer or chronic pancreatitis. We report herein the performance of a videothoracoscopic left splanchnicectomy in a patient with a previous right pneumonectomy who suffered intractable pain from an irresectable left adrenal metastasis associated with metastatic retroperitoneal lymph nodes. Immediate pain relief was obtained, but abdominal pain of middle intensity recurred 6 weeks later. Although infrequently required, this procedure might be of value in some patients with refractory pain.