Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

Abstract

Despite the development of vascular reconstruction techniques, thoracic sympathectomy still represents a valid therapeutic option for certain ischemic disorders. In selected patients for which direct revascularization is not feasible because of the very peripheral localization of vascular lesions, sympathectomy maximizes tissue preservation thus preventing or delaying major amputation and it permits optimal pain control. Also, thoracic sympathectomy can be safely performed with a minimally invasive technique, reducing operative time and morbidity. We report the case of a patient with peripheral ischemic disease of his right hand that was successfully treated by endoscopic thoracic sympathectomy. Surgery was safe and effective in controlling pain and maximizing tissue preservation, preventing major amputation.