Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique

Anniek M van Roon*, Michiel Kuijpers, Saskia C van de Zande, Amaal Eman Abdulle, Arie M van Roon, Reinhard Bos, Wobbe Bouma, Theo J Klinkenberg, Hendrika Bootsma, Mike J L DeJongste, Massimo A Mariani, Andries J Smit, Douwe J Mulder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
27 Downloads (Pure)

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.

Original languageEnglish
Pages (from-to)1021-1025
Number of pages5
JournalRheumatology
Volume59
Issue number5
Early online date16-Sep-2019
DOIs
Publication statusPublished - May-2020

Keywords

  • Raynaud's phenomenon
  • sympathicotomy
  • blood perfusion
  • laser speckle contrast analysis
  • THORACIC SYMPATHECTOMY
  • SYSTEMIC-SCLEROSIS
  • DIGITAL ISCHEMIA

Cite this