P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE
Background: Raynaud’s phenomenon of the hands is a great burden and reduces quality of life. In some patients, complaints may be resistant to vasodilatory treatment, for which additional options are very limited. Previously thoracic sympathectomy has been shown effective, but with great surgical bur...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Atlantis Press
2018-12-01
|
Series: | Artery Research |
Online Access: | https://www.atlantis-press.com/article/125930053/view |
id |
doaj-bd7ad8c0c17942c495ebcbf2abba5812 |
---|---|
record_format |
Article |
spelling |
doaj-bd7ad8c0c17942c495ebcbf2abba58122020-11-25T01:28:31ZengAtlantis PressArtery Research 1876-44012018-12-012410.1016/j.artres.2018.10.111P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUEAnniek van RoonMichiel KuijpersSaskia van de ZandeArie van RoonMassimo MarianiReinhard BosHendrika BootsmaTheo KlinkenbergAndries SmitUdo MulderBackground: Raynaud’s phenomenon of the hands is a great burden and reduces quality of life. In some patients, complaints may be resistant to vasodilatory treatment, for which additional options are very limited. Previously thoracic sympathectomy has been shown effective, but with great surgical burden. In our centre, single-port thoracoscopic sympathicotomy (SPTS) was developed, a new minimally invasive endoscopic technique extensively limiting surgical burden. Objectives: The aim of this pilot study was to evaluate feasibility and efficacy of SPTS in patients with treatment resistant Raynaud’s. Methods: In the current study, we aim to include 10 patients with treatment resistant Raynaud’s. SPTS was performed on the left side and the effects were compared contralateral after 1 and 12 months. To assess perfusion of the hands a cooling fingertip plethysmography (PPG) and laser Doppler imaging (LDI) were used. Pulse wave velocity (PWV) of the carotis-femoralis and carotis-radialis was measured. Results: During this interim report, 7 patients are included so far (age 42 ± 13 years, 5/2 male/female, 5/2 primary/secondary Raynaud’s). All 7 patients were satisfied. A clear improvement in hand perfusion was observed with LDI and PPG during cooling, as compared to the contralateral side. A trend in decrease of PWV carotis-radialis left was seen, while PWV at the other sites did not change significantly (figure 1). Conclusions: SPTS is a novel minimally invasive technique which appears to be safe and feasible in patients with treatment resistant Raynaud’s and increases hand perfusion. However, this study is on-going and long-term efficacy needs to be established.https://www.atlantis-press.com/article/125930053/view |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anniek van Roon Michiel Kuijpers Saskia van de Zande Arie van Roon Massimo Mariani Reinhard Bos Hendrika Bootsma Theo Klinkenberg Andries Smit Udo Mulder |
spellingShingle |
Anniek van Roon Michiel Kuijpers Saskia van de Zande Arie van Roon Massimo Mariani Reinhard Bos Hendrika Bootsma Theo Klinkenberg Andries Smit Udo Mulder P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE Artery Research |
author_facet |
Anniek van Roon Michiel Kuijpers Saskia van de Zande Arie van Roon Massimo Mariani Reinhard Bos Hendrika Bootsma Theo Klinkenberg Andries Smit Udo Mulder |
author_sort |
Anniek van Roon |
title |
P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE |
title_short |
P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE |
title_full |
P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE |
title_fullStr |
P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE |
title_full_unstemmed |
P58 SINGLE-PORT THORACOSCOPIC SYMPATHICOTOMY FOR TREATMENT RESISTANT RAYNAUD’S PHENOMENON: FIRST REPORT OF A NOVEL MINIMALLY INVASIVE ENDOSCOPIC TECHNIQUE |
title_sort |
p58 single-port thoracoscopic sympathicotomy for treatment resistant raynaud’s phenomenon: first report of a novel minimally invasive endoscopic technique |
publisher |
Atlantis Press |
series |
Artery Research |
issn |
1876-4401 |
publishDate |
2018-12-01 |
description |
Background: Raynaud’s phenomenon of the hands is a great burden and reduces quality of life. In some patients, complaints may be resistant to vasodilatory treatment, for which additional options are very limited. Previously thoracic sympathectomy has been shown effective, but with great surgical burden. In our centre, single-port thoracoscopic sympathicotomy (SPTS) was developed, a new minimally invasive endoscopic technique extensively limiting surgical burden.
Objectives: The aim of this pilot study was to evaluate feasibility and efficacy of SPTS in patients with treatment resistant Raynaud’s.
Methods: In the current study, we aim to include 10 patients with treatment resistant Raynaud’s. SPTS was performed on the left side and the effects were compared contralateral after 1 and 12 months. To assess perfusion of the hands a cooling fingertip plethysmography (PPG) and laser Doppler imaging (LDI) were used. Pulse wave velocity (PWV) of the carotis-femoralis and carotis-radialis was measured.
Results: During this interim report, 7 patients are included so far (age 42 ± 13 years, 5/2 male/female, 5/2 primary/secondary Raynaud’s). All 7 patients were satisfied. A clear improvement in hand perfusion was observed with LDI and PPG during cooling, as compared to the contralateral side. A trend in decrease of PWV carotis-radialis left was seen, while PWV at the other sites did not change significantly (figure 1).
Conclusions: SPTS is a novel minimally invasive technique which appears to be safe and feasible in patients with treatment resistant Raynaud’s and increases hand perfusion. However, this study is on-going and long-term efficacy needs to be established. |
url |
https://www.atlantis-press.com/article/125930053/view |
work_keys_str_mv |
AT anniekvanroon p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT michielkuijpers p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT saskiavandezande p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT arievanroon p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT massimomariani p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT reinhardbos p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT hendrikabootsma p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT theoklinkenberg p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT andriessmit p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique AT udomulder p58singleportthoracoscopicsympathicotomyfortreatmentresistantraynaudsphenomenonfirstreportofanovelminimallyinvasiveendoscopictechnique |
_version_ |
1725101168141533184 |