The comparative characteristic of open and chemical desympathization lumbar ganglia when recurrent ischemia after reconstructive operations on the arteries of the lower extremities

Abstract

A comparison of efficiency of open and chemical desympathization lumbar ganglia in patients with recurrent ischemia of lower extremities after reconstructive surgeries. Lumbar sympathectomy was used in addition to reconstructive surgery on vessels in 43 patients, chemical destruction of sympathetic ganglia 26 patients with distal type lesions of the arteries of the legs after 4-8 days after the arterial reconstruction in the lower limbs. It is revealed, that alternative to traditional lumbar sympathectomy is a minimally invasive technique of chemical destruction of the lumbar sympathetic ganglia performed under the control of the spiral computer tomography. It has comparable efficacy compared with open interference in both the immediate and long-term care.

Sympathectomy and Neuromodulation in the Treatment of Critical Lower Limb Ischemia

“…Открытая техника ПСЭ вызывает слабость мышц передней брюшной стенки на стороне доступа и увеличение сроков госпитализации, что тормозит большую часть хирургов перед ее выполнением [36][37][38]. С развитием современных технологий в последнее время разработана ПСЭ с применением транскутанных технологий и методов нейровизуализации (рентген или компьютерный томографический (КТ) контроль).…”

“…Непосредственные результаты показали сопоставимость полученных данных (хорошие исходы - 2 =0,04, р=0,8; удовлетворительные и неудовлетворительные исходы - 2 =0,01, р=0,9). В послеоперационном периоде наблюдали у 32% пациентов (12/38) со стороны ПСЭ слабость передней брюшной стенки, а осложнений при перкутанной ПСЭ не было [36].…”

Computed tomography-controlled paravertebral sympathectomy in the treatment of obliterating diseases of the arteries of extremities

“…Operative treatment in the sympathetic nervous system retains their relevance to this day and continue to be a method of pathogenetic influence on the vascular bed in obliterating arteries diseases. Simultaneously with the improvement of medical technologies and the constant increase in the number of reconstructive vascular surgeries for obliterating diseases of the arteries of the extremities, works on a significant number of failures in the early and long-term postoperative periods also began to appear [2].…”

“…They become surgeries of choice in cases of peripheral arterial damage. Regional sympathectomy causes arterial dilation and an increase in blood flow to the ischemic zone, improves microcirculatory flow, reduces peripheral resistance to blood flow and ischemic edema, positively affects tissue trophicity, accelerates angiogenesis processes in the occlusive zone [2].…”

“…Collaterals are also not damaged. They are in a state of spasm under the influence of stimuli coming out of the places of vascular occlusion of the main vessels [2].…”