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Treatment of resistant Raynaud's phenomenon with single-port thoracoscopic sympathicotomy: a novel minimally invasive endoscopic technique

van Roon, A. M., Kuijpers, M., van de Zande, S. C., Abdulle, A. E., van Roon, A. M., Bos, R., Bouma, W., Klinkenberg, T. J., Bootsma, H., DeJongste, M. J. L., Mariani, M. A., Smit, A. J. & Mulder, D. J., 16-Sep-2019, In : Rheumatology. 5 p.

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  • Treatment of resistant Raynaud’s phenomenon with single-port thoracoscopic sympathicotomy a novel minimally invasive endoscopic technique

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OBJECTIVE: To assess the minimally invasive single-port thoracoscopic sympathicotomy feasibility and efficacy in patients with treatment-resistant RP.

METHODS: Single-port thoracoscopic sympathicotomy was performed unilaterally on the left side in eight patients with RP (six males, two females, with a median age of 45.2 years). Five patients had primary and three had secondary RP. Perfusion effects in the hands were assessed at baseline and after 1 month by using a cooling and recovery procedure, and by using laser speckle contrast analysis. Number and duration of RP attacks were reported over a 2-week period.

RESULTS: Patient satisfaction was 100% after surgery. After surgery, a unilateral improvement in perfusion was observed in the left hand compared with the right hand, with cooling and recovery (P = 0.008) and with laser speckle contrast analysis (P = 0.023). In addition, the number and duration of the attacks in the left hand decreased compared with the right hand (both P = 0.028). No serious adverse events occurred in a follow-up period of at least 10 months.

CONCLUSION: Single-port thoracoscopic sympathicotomy is feasible and can be effective in improving hand perfusion in patients with RP. However, long-term efficacy needs to be established.

CLINICAL TRIAL REGISTRATION NUMBER: NCT02680509.

Original languageEnglish
Number of pages5
JournalRheumatology
Publication statusE-pub ahead of print - 16-Sep-2019

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