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Lumbar Sympathectomy
Sympathectomy Lumbar

Presentation

Patients with persistent PHH who underwent ERLS presented values close to ideal in the QOL indices related to HH. The mean scores of QOL after ERLS in the test groups presented a considerable decrease from 48.8 to 26.33. [scielo.br]

A pneumoperitoneum was present in 10 procedures, but a Veress needle was placed in only 4 of these. [ncbi.nlm.nih.gov]

Hematological

  • Subcutaneous Bleeding

    Bleeding from the subcutaneous tissue, retroperitoneal space and anaesthesia did not complicate the procedure – respectively 1.33; 1; 0.75/10. [termedia.pl]

Entire Body System

  • Gangrene of the Toe

    […] of the toes. [ncbi.nlm.nih.gov]

Urogenital

  • Sexual Dysfunction

    Several recent articles have reported no sexual dysfunction in men undergoing the operation. It has been reported that as long as the sympathectomy is performed below the L2 ganglion, sexual dysfunction did not occur. [med.nyu.edu]

    None of the patients experienced sexual dysfunction. Five patients (62%) reportedly experienced minor compensatory sweating of the torso, and four patients (50%) had postsympathectomy neuralgia. [ncbi.nlm.nih.gov]

    Sexual dysfunction It consists of retrograde ejaculation, and occurs in 25-50% patients undergoing bilateral LS including the L 1 sympathetic ganglia. [orion-group.net]

Workup

X-Ray

  • Pneumoperitoneum

    Complications included 3 cases (6%) of accidental peritoneal tear and pneumoperitoneum which were resolved by insertion of a Veress needle in the hypochondrium; 2 (4%) retroperitoneal hematoma, and 6 (12%) superficial wound infections. [ncbi.nlm.nih.gov]

Treatment

This case study illustrates the role of the Podiatrist in the primary health care team and how a multidisciplinary approach to treatment promotes successful diagnosis and treatment regimes. [ncbi.nlm.nih.gov]

Lumbar Sympathectomy: The lumbar sympathectomy was initially utilized for the treatment of ischemic and painful disorders of the lower limbs. This treatment, which was popular among vascular surgeons, remained unchanged for several decades. [laparoscopyhospital.com]

Prognosis

Prognosis The disease is progressive in patients who do not stop smoking. The only way to prevent the progression of the disease is to abstain from all tobacco products. [patient.info]

Etiology

J Bone Joint Surg (Br), 1950, 32, 325-333. [5] Newman PH, Stone KH : The etiology of spondylolisthesis. [em-consulte.com]

Epidemiology

Epidemiology The prevalence of the disease is decreasing in developed countries. Interestingly, the rate of decrease is more closely linked with improvements in socio-economic factors than with smoking status [ 5 ]. [patient.info]

Pathophysiology

The pathophysiology is thought to involve endothelial cells, platelets, leukocytes and sensory neurons. [patient.info]

Peripheral artery disease: pathophysiology, diagnosis and treatment. Rev Esp Cardiol 2007; 60: 969-82. 7. Perez-Burkhardt JL, Gonzalez-Fajardo JA, Martin JF, et al. [termedia.pl]

"The pathophysiology of cervical and upper thoracic sympathetic surgery". Clinical Autonomic Research. 13 : I40–4. doi : 10.1007/s10286-003-1105-3. PMID 14673672. ^ a b Kawamata YT, Homma E, Kawamata T, Omote K, Namiki A (2001). [en.wikipedia.org]

Prevention

BACKGROUND: Lumbar sympathectomy (LS) is often the only alternative treatment that can be considered as a means of improving the distal circulation to such extent that major amputation is prevented. [ncbi.nlm.nih.gov]

This disease should be diagnosed promptly to prevent unnecessary progression. [annals.org]

It can negatively affect marital or other intimate relationships, prevent participation in barefoot activities, ruin shoes, and cause skin infections as well as lesions. [laparoscopyhospital.com]

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