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Lumbar Sympathectomy


Presentation

  • A pneumoperitoneum was present in 10 procedures, but a Veress needle was placed in only 4 of these.[ncbi.nlm.nih.gov]
  • The aim of the present study was to provide anatomic data from CT images and to discuss the safest route for needle insertion.[ncbi.nlm.nih.gov]
  • METHODS: We present a series of five lumbar sympathectomies performed laparoscopically. RESULTS: All patients sustained symptomatic relief and no postoperative complications were noted.[ncbi.nlm.nih.gov]
  • Compensatory sweating, already present in those with prior thoracic sympathectomy (n 56), remained unchanged in 91.1% and no severe compensatory sweating occurred in those who had only ELS. Postoperative pain was minimal.[ncbi.nlm.nih.gov]
  • Abstract We present a series of 27 consecutive unselected patients who underwent 29 retroperitoneoscopic lumbar sympathectomies. There were 21 male patients and six female patients, with a mean age of 45 years (RANGE, 21 to 28 years).[ncbi.nlm.nih.gov]
Severe Pain
  • Average baseline scores of 8-9/10 on several pain scales fell to about 4/10 initially (1 day) and remained at 3-5/10 over four months.[ncbi.nlm.nih.gov]
  • If you experience any severe pain, weakness or numbness, swelling, fevers, chills, severe headaches, bleeding/discharge from the wounds, or if you have any other concerns then please contact NIPM or the Day Hospital centre.[newcastlepainmanagement.com.au]
Tenesmus
  • Abstract Lumbar sympathectomy was performed in twelve patients whose main or sole complaint was rectal tenesmus resulting from pelvic carcinoma, and in whom psychotropic drugs had failed to control their symptom.[ncbi.nlm.nih.gov]
Anhidrosis
  • All patients had improvement in foot sweating, with 96.6% achieving total anhidrosis. Five early cases had to be converted to an open surgical method. Complications were rare. No sexual problems were reported by the male patients.[ncbi.nlm.nih.gov]
  • The patient had anhidrosis of both feet after surgery with Hyperhidrosis Disease Severity Scale score of 1 at the 1-month follow-up.[ncbi.nlm.nih.gov]
  • Plantar anhidrosis was achieved in all the patients, although two patients (20%) suffered a relapse. Unwanted side-effects occurred in the form of compensatory sweating in three patients (30%) and post-sympathectomy neuralgia in two patients (20%).[ncbi.nlm.nih.gov]
  • After a 3- to 8-month follow-up period, the anhidrosis persisted in all cases (100%). None of the patients experienced sexual dysfunction.[ncbi.nlm.nih.gov]
Skin Lesion
  • BACKGROUND: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2[ncbi.nlm.nih.gov]
  • Background: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2[cochrane.org]

Workup

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

  • The mainstay of treatment for CLI is surgical or endovascular repair. However, when these means of treatment are not suitable, due to anatomical reasons or comorbidities, treatment for pain is limited.[ncbi.nlm.nih.gov]
  • 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]
  • SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any of the treatment modalities of lumbar sympathectomy, such as open, laparoscopic and chemical percutaneous methods, with no treatment or with any other method of lumbar sympathectomy[ncbi.nlm.nih.gov]
  • Sympathectomy may be compared with placebo (sham) or other active treatment, provided both participants and outcome assessors are blind to treatment group allocation.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: This study showed CLS provides a valid option for the treatment of idiopathic LR. The efficacy of CLS can be long-lasting, and CLS can be repeated if LR recurs.[ncbi.nlm.nih.gov]

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]
  • AVPST is meaningful in fetal monitoring, that is, positive result of AVPST indicates favourable condition of fetus, while negative result means unfavourable prognosis. Gera [37675 ] ra /di CHAGUE-GAGNERET C PHYSIOLOGIE DE LA GROSSESSE EN MTC.[acupuncture-medicale.org]

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]
Sex distribution
Age distribution

Pathophysiology

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

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]
  • The lung prevents a good view of the nerve so the anaesthetist reduces the breathing on this side and the lung becomes less inflated.[vascularsociety.org.uk]

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