Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: One-year follow-up
Michiel Kuijpers, Saskia C van de Zande, Anniek M van Roon, Arie M van Roon, Alja J Stel, Andries J Smit, Wobbe Bouma, Mike J L DeJongste, Massimo A Mariani, Theo J Klinkenberg, Douwe J Mulder, Michiel Kuijpers, Saskia C van de Zande, Anniek M van Roon, Arie M van Roon, Alja J Stel, Andries J Smit, Wobbe Bouma, Mike J L DeJongste, Massimo A Mariani, Theo J Klinkenberg, Douwe J Mulder
Abstract
Objective: Follow-up of patients with treatment-resistant Raynaud's phenomenon (RP) one-year after single-port thoracoscopic sympathicotomy (SPTS).
Methods: Eight patients (six males, two females, median age of 45 years) with treatment-resistant RP underwent left-sided SPTS at the third rib (R3), unilaterally. Questionnaires were taken, and number and duration of RP attacks were reported over a 2-week period. Perfusion was assessed with a cooling and recovery procedure at baseline and one year after SPTS. Furthermore, laser speckle contrast analysis, pulse wave velocity, heart rate variability and nailfold capillary microscopy were performed.
Results: One year after SPTS the duration of the attacks of was reduced with 1.9 h in the left hand versus 0.3 h in the right hand. Furthermore, three aspects of the questionnaire showed a significant improvement (role limitations due to physical health (p = 0.017), pain (p = 0.027) and physical functioning (p = 0.025)). The total area under the curve of the total cooling and recovery procedure of the left hand was larger one year after surgery (101 (75-140) at baseline versus 118 (95-190) one year post-operatively, p = 0.012), implying a better perfusion in the fingers. This was mainly due to the improvement during the recovery phase (21 (1-41) at baseline versus 38 (24-43) one year post-operatively, p = 0.028).
Conclusion: One year after unilateral R3 SPTS the benefit with regard to the majority of outcome variables persisted, though some effects seem to attenuate. Long-term effects and long-term follow-up results will be investigated in an on-going study.
Clinical trial registration number: NCT02680509.
Keywords: Blood perfusion; Raynaud's diary; Raynaud's phenomenon; Sympathicotomy.
Conflict of interest statement
Declaration of Competing Interest The authors have declared no conflicts of interest.
Copyright © 2022. Published by Elsevier Inc.
Source: PubMed