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Hidehiro Yamamoto, Masayoshi Okada
OBJECTIVE: Endoscopic thoracic sympathectomy at the second rib level is considered effective as a therapeutic treatment for facial blushing. However, 10% to 15% of patients do not benefit from this intervention. No additional procedure has been developed for this disorder. Recently, ganglionectomy using application of laser speckle flow graph has been evaluated for the treatment of compensatory sweating. We report our results of ganglionectomy for facial blushing as a redo surgery. METHODS: Between August 2012 and April 2017, 8 patients with facial blushing who underwent an initial sympathectomy reported symptom recurrence...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Timothy L Surman, Robert G Stuklis, Justin C Chan
BACKGROUND: Multiple case studies have suggested that video-assisted thoracoscopic sympathectomy (VATS) reduces the occurrence and frequency of symptoms in long QT syndrome (LQTS) [1,2,3]. To date there has not been a literature review to report on the short-term and long-term outcomes of this procedure. Our primary aims are to review the literature findings on the clinical outcomes of VATS sympathectomy for long QT and present a local centre case report on the outcomes of T2-T5 sympathectomy...
February 13, 2018: Heart, Lung & Circulation
Sean C Maguire, Christina A Fleming, Gavin O'Brien, Gerald McGreal
BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive)...
March 7, 2018: Irish Journal of Medical Science
Brody Wehman, Michael Mazzeffi, Robert Chow, A Claire Watkins, Brittany Aicher, Si Pham, Whitney Burrows, Bradley Taylor
We report a patient with refractory electrical storm after coronary artery bypass grafting who was successfully treated with thoracoscopic sympathectomy. Cardiac arrest with ventricular tachycardia occurred on postoperative day 2, and the patient required emergency support with venoarterial extracorporeal membrane oxygenation. Frequent episodes of ventricular tachycardia prevented cardiac recovery and weaning from mechanical circulatory support. A percutaneous left stellate ganglion block initially demonstrated successful prevention of ventricular tachycardia, and definitive sympathetic denervation was achieved by a left thoracoscopic sympathectomy...
March 2018: Annals of Thoracic Surgery
Hadeel A Alsufyani, James R Docherty
We have investigated the cardiac and pressor responses to (±)-ephedrine and (-)-ephedrine in pentobarbitone anaesthetised male wistar rats. The tachycardiac responses to (±)- and (-)-ephedrine were similar, but pressor responses to (-)-ephedrine (10mg/kg) were significantly greater than those to (±)-ephedrine, and for both, the pressor response was followed by a small depressor response. Sympathectomy did not affect pressor responses, but significantly increased the later depressor response to both compounds...
February 15, 2018: European Journal of Pharmacology
Marcello Migliore, Manuela Palazzolo, Manuela Pennisi, Marco Nardini, Francesco Borrata
Hyperhidrosis affect 3% of the population and, despite benign nature of the disease, the individuals seek medical advice in order to improve their quality of life which can be severely compromised. The interruption of the sympathetic chain (sympathectomy) and of the nerve of Kuntz established its role as the definitive treatment of primary hyperhidrosis. In this manuscript, we present our extended uniportal technique with the aid of the video. Uniportal approach expresses all its benefit when applied for this procedure because there is no specimen to be retrieved and all the surgery is accomplished through a 1-2 cm port access...
2018: Journal of Visualized Surgery
Tom B Mole, Pieter Mackeith
Postoperative neuropathic pain exacerbated by movement is poorly understood and difficult to treat but a relatively common complication of surgical procedures such as endoscopic thoracic sympathectomy. Here, we describe a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions. Though an incidental chance association is possible, the clear temporal proximity linking the swim with pain remission makes a causal relationship possible...
February 12, 2018: BMJ Case Reports
Zhifang Zheng, Yishu Liu, Lulu Zhu, Jianbing Tang, Wenhua Huang, Biao Cheng
BACKGROUND: The effect of lumbar sympathectomy for the treatment of lower limb ischemia remains a matter of controversy. METHODS: Sprague-Dawley rats were subjected to lumbar sympathectomy, after which Evans blue dye was injected into the hind plantar skin. Extravasation of dye was measured and compared with rats undergoing sham operation. Hind plantar skin was processed for HE staining, immunohistochemistry, and Western blot. RESULTS: In sympathectomized rats, blue stained areas in hind plantar skin and concentrations of Evans blue were significantly less than that of sham sympathectomy (control) rats, both 2 weeks and 3 months after surgery...
2018: Clinical Hemorheology and Microcirculation
Hee Suk Jung, Doo Yun Lee, Joon Suk Park
Recurrent hyperhidrosis after thoracic sympathectomy is an uncomfortable condition, and compensatory hyperhidrosis (CH) is one of the most troublesome side effects. Here, we describe two patients with recurrent palmar hyperhidrosis (PH) and CH over the whole body simultaneously. They were treated with bilateral T4 sympathetic clipping and reconstruction of the sympathetic nerve from a T5 to T8 sympathetic nerve graft, which was transferred to the resected T3 sympathetic bed site. They reported improvements in sweating and were fully satisfied with the results...
March 2018: Yonsei Medical Journal
José Johann Chidiac, Ammar Kassab, Khaldoun Rifai, Nayef E Saadé, Elie D Al Chaer
INTRODUCTION: Intact neural supply is necessary for tooth eruption. Sympathetic denervation accelerates or decelerates the eruption rate depending on the tooth condition (intact or injured). The aim of this study is to reexamine the role of the sympathetic innervation, through the observation of the effects of pre or post ganglionic chemical sympathectomy on the eruption of intact rat incisors. MATERIALS AND METHODS: Different groups of rats were subjected to either ganglionic or peripheral chemical sympathectomy and the observed effects on incisor eruption were compared to those made on intact/sham groups or on rats subjected to inferior alveolar nerve (IAN) lesion...
February 7, 2018: Archives of Oral Biology
Aravind Krishnan, Alejandro Suarez-Pierre, Todd C Crawford, Xun Zhou, Stuart D Russell, Ronald D Berger, Hugh Calkins, William A Baumgartner, Harikrishna Tandri, Kaushik Mandal
We describe the novel use of bilateral cardiac sympathectomy in a woman with end-stage heart failure caused by ventricular tachycardia refractory to standard medical therapy who was under consideration for heart transplantation. Postoperatively, our patient has not experienced any symptoms of ventricular tachycardia, has returned to normal physical activity, and is no longer under consideration for transplantation as a result of the improvement in her cardiac function. Bilateral sympathectomy can be more effective than unilateral sympathectomy or percutaneous stellate ganglion blockade in patients with refractory ventricular tachycardia...
February 2018: Annals of Thoracic Surgery
Sami Karapolat, Atila Turkyilmaz, Celal Tekinbas
INTRODUCTION: Raynaud's disease is a disorder that is characterized by attacks of pain, cyanosis, redness, and numbness in the upper extremities caused by vasospasm of digital arteries due to cold or emotional stress. We aimed at demonstrating our experiences with endoscopic thoracic sympathectomy (ETS) in the treatment of Raynaud's disease. METHODS: From 48 patients who underwent ETS for various reasons at our department between January 2014 and January 2015, we reviewed 9 patients with Raynaud's disease (18...
January 12, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
James W Pritchett
PURPOSE: During hip replacement, nerves in the operative field can be injured accidently. Additional surgical procedures can help restore function and reduce pain if there has been no recovery. METHODS: One-hundred sixty-two patients presented with nerve injuries, and 113 were candidates for surgical treatment. The author performed 91 procedures on the injured limb (80 patients; 11 had 2 procedures) consisting of shortening, sympathectomy, tendon transfer, neurolysis or nerve repair/graft and 30 spinal and three fibular-neck decompressions...
December 28, 2017: International Orthopaedics
E L Kalmykov, I A Suchkov, O N Niematzoda
No abstract text is available yet for this article.
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Mohammad-Hadi S Modaghegh, Shahab Hafezi
PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included...
February 2018: Vascular and Endovascular Surgery
Achilleas Antonopoulos, David Lawrence, Davide Patrini, Marco Scarci, Robert George, Martin Hayward, Sofoklis Mitsos, Nikolaos Panagiotopoulos
Long QT syndrome (LQTS) is an uncommon and potentially fatal cardiac channelopathy. Treatment options can be medical with β-blockers or surgical with implantable cardioverter defibrillator (ICD) implantations and left cardiac sympathetic denervation (LCSD). Purpose of this paper is through a literature review to identify the management algorithm and the role of sympathectomy in LQTS.
September 2017: Journal of Thoracic Disease
Alexandre Kanashiro, Marcelo Franchin, Gabriel Shimizu Bassi, Dênis Augusto Reis Santana, Thiago Mattar Cunha, Fernando Queiróz Cunha, Luis Ulloa, Gerson Jonathan Rodrigues
The central nervous system controls the innate immunity by modulating efferent neuronal networks. Recently, we have reported that central brain stimulation inhibits inflammatory responses. In the present study, we investigate whether spinal p38 mitogen-activated protein kinase (MAPK) affects joint inflammation in experimental arthritis. Firstly, we observed that intra-articular administration of zymosan in mice induces the phosphorylation of the spinal cord p38 MAPK. In addition, we demonstrated that spinal p38 MAPK inhibition with intrathecal injection of SB203580, a conventional and well-characterized inhibitor, prevents knee joint neutrophil recruitment, edema formation, experimental score and cytokine production...
December 5, 2017: Fundamental & Clinical Pharmacology
Mu-Lien Lin, Tzu-Rung Huang, Ming-Chien Kao, Hung-Wei Chiu, Sheng-Chieh Lin, Fang-Chia Chang
Objectives: Palmar hyperhidrosis (PH) exhibits excessive and unpredictable sweating. The most effective treatment for permanent cure is the ablation of thoracic sympathetic ganglia innervating hands. However, sympathectomy of T2 sympathetic ganglion by clipping or cauterization causes irreversible nerve damage, and results in a compensatory hyperhidrosis (CH). We herein used the pulsed radiofrequency (PRF) stimulation to reversibly block sympathetic ganglion to treat PH and avoid CH. Material and Methods: A bipolar electrode was implanted into the right T2 sympathetic trunk by endoscopic surgery and PRF was delivered through the electrode...
November 2017: Brain and Behavior
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
November 16, 2017: A & A Case Reports
S M Hermelijn, I H Boersma, M H Dekker, S van Duin, J M Schnater
BACKGROUND: Palmar and axillary hyperhidrosis are defined as perspiration exceeding the body's 'normal' physiological need for thermal regulation. This condition affects about 1% of adolescents and children and may lead to psychosocial problems and poor school performance. CASE DESCRIPTION: We carried out an endoscopic thoracic sympathectomy (ETS) with clips in a 14-year-old girl and a 16-year-old girl who suffered from debilitating palmar and axillary hyperhidrosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
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