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

doi:10.1093/rheumatology/kez386

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 journal › Article › Academic › peer-review

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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 language	English
Pages (from-to)	1021-1025
Number of pages	5
Journal	Rheumatology
Volume	59
Issue number	5
Early online date	16-Sept-2019
DOIs	https://doi.org/10.1093/rheumatology/kez386
Publication status	Published - May-2020

Keywords

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

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Treatment of resistant Raynaud’s phenomenon with single-port thoracoscopic sympathicotomy a novel minimally invasive endoscopic techniqueFinal publisher's version, 355 KBLicence: CC BY-NC

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van Roon, A. M., Kuijpers, M., van de Zande, S. C., Abdulle, A. E., van Roon, A. M., Bos, R., Bouma, W., Klinkenberg, T. J., Bootsma, H., DeJongste, M. J. L., Mariani, M. A., Smit, A. J., & Mulder, D. J. (2020). Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique. Rheumatology, 59(5), 1021-1025. https://doi.org/10.1093/rheumatology/kez386

@article{1cce56861b75457194726d2f85bb1bcb,

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

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.",

keywords = "Raynaud's phenomenon, sympathicotomy, blood perfusion, laser speckle contrast analysis, THORACIC SYMPATHECTOMY, SYSTEMIC-SCLEROSIS, DIGITAL ISCHEMIA",

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

note = "{\textcopyright} The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].",

year = "2020",

month = may,

doi = "10.1093/rheumatology/kez386",

language = "English",

volume = "59",

pages = "1021--1025",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "5",

}

van Roon, AM, Kuijpers, M, van de Zande, SC , Abdulle, AE , van Roon, AM, Bos, R, Bouma, W , Klinkenberg, TJ , Bootsma, H, DeJongste, MJL, Mariani, MA , Smit, AJ & Mulder, DJ 2020, 'Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique', Rheumatology, vol. 59, no. 5, pp. 1021-1025. https://doi.org/10.1093/rheumatology/kez386

TY - JOUR

T1 - Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy

T2 - a novel minimally invasive endoscopic technique

AU - van Roon, Anniek M

AU - Kuijpers, Michiel

AU - van de Zande, Saskia C

AU - Abdulle, Amaal Eman

AU - van Roon, Arie M

AU - Bos, Reinhard

AU - Bouma, Wobbe

AU - Klinkenberg, Theo J

AU - Bootsma, Hendrika

AU - DeJongste, Mike J L

AU - Mariani, Massimo A

AU - Smit, Andries J

AU - Mulder, Douwe J

PY - 2020/5

Y1 - 2020/5

N2 - 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.

AB - 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.

KW - Raynaud's phenomenon

KW - sympathicotomy

KW - blood perfusion

KW - laser speckle contrast analysis

KW - THORACIC SYMPATHECTOMY

KW - SYSTEMIC-SCLEROSIS

KW - DIGITAL ISCHEMIA

U2 - 10.1093/rheumatology/kez386

DO - 10.1093/rheumatology/kez386

M3 - Article

C2 - 31529103

SN - 1462-0324

VL - 59

SP - 1021

EP - 1025

JO - Rheumatology

JF - Rheumatology

IS - 5

ER -

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

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Keywords

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