Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SYMPATHECTOMY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed2004

[Hardship of development of mini-invasive surgery: the hard history of sympathectomy].

The authors review the history of sympathectomy in the past more than fifty years and divide the whole course into four stages: thoracotomy, attempting toward mini-invasion, conventional thoracoscopy and video-assisted thoracoscopy (VATS). Emphasis is laid on the difficult course of how this procedure has developed step by step from its original embarrassed 'large incision, small surgery' status to the modern mini-invasion surgery. The fact has proved that it is the modern natural science particularly the development and utilization of modern instruments that has notably promoted, and will continuously promote, the whole surgery toward mini-invasion.

Humans↗
PubMed1992

Influences of chemical sympathectomy, demedullation, and hindlimb suspension on the VO2max of rats.

Results from previous studies have shown that the reduction in maximal oxygen consumption (VO2max) with simulated microgravity is attenuated in chemically sympathectomized rats. To determine the contributions of the catecholamines from the adrenal medulla in this process, investigations were conducted with 65 saline injected (SAL) and chemically sympathectomized (SX) female rats that were either surgically demedullated (DM), or intact (IN). Microgravity conditions were simulated by head-down suspension (HDS) while controls were assigned to individual cages (CC). The experimental period was 14 d. The rats were tested for VO2max, treadmill run time (RT), and submaximal mechanical efficiency (ME) prior to suspension and on days 7 and 14. Saline injected rats that had intact adrenal medullas (SAL-IN) exhibited significantly reduced measures of VO2max after 7 and 14 d by 15% and 21%, respectively. No significant reduction in VO2max was observed with HDS in the SX-IN animals. Sympathectomized rats that were demedullated (SX-DM) also exhibited a significant reduction in VO2max (12%). In addition, HDS was associated with a marked and significant reduction in RT in all groups. ME for submaximal exercise was significantly reduced after HDS in SAL-IN rats but not in the SX-IN rats. SX-DM rats experienced significant reductions in ME similar in magnitude to the SAL-IN rats. These results confirm that chemical sympathectomy attenuates the expected decrease in VO2max with HDS and suggests that circulating epinephrine contributes to this response.

Adrenal Medulla↗
PubMed2005

Percutaneous lumbar sympathectomy in the treatment of erectile dysfunction secondary to cavernous adrenergic hypertone: initial results of an original technique.

Corporeal smooth muscle tone is regulated by a delicate balance between contraction and erectile smooth muscle. An abnormal balance in basal conditions, due to an augmented contraction of erectile smooth muscle, defined "dysfunctional antagonism", may be responsible of a particular condition of erectile dysfunction (ED), secondary to cavernous adrenergic hypertone (CAY). In order to investigate the possibility to treat CAY with a definitive inhibition of adrenergic innervation to corpora cavernosa, we evaluated the results of an original technique of percutaneous lumbar sympathectomy (PLS) in a group of patients with clinical signs and symptoms of CAY In our study, 14 patients were selected and treated with PLS. Pre-treatment evaluation was designed to identify patients with ED caused by CAY, eligible for surgical treatment, and consisted of medical history, the self administered International Index of Erectile Function and Doppler sonography evaluation of cavernous arteries. Were considered eligible to the surgical treatment the patients with normal PSV values and abnormal EDV values after first injection of alprostadil, but reduced to zero after redosing with alprostadil and phentolamine. All these patients were treated with percutaneous bilateral lumbar ganglionic block with mepivacaine and, at a successive time, phenol 4% and evaluated after I and 4 months. Each evaluation consisted of a self-administered IIEF questionnaire, physical examination and Doppler sonography evaluation. Among the 14 patients selected and treated with temporary block with mepivacaine, 3 reported significant adverse events, consisting of loss of ejaculation (2 patients) and severe lumbar pain (1 patient). In all the other patients treated, only mild to moderate lumbar pain was reported. 10 patients out of the 14 treated with mepivacaine accepted to undergo the successive step of ganglionic block with phenol. Nine patients reported improved erections at both visits, as assessed by the GEQ. Moreover, the analysis of responses to IIEF questions 2-3 showed a highly significant improvement in erectile function compared to scores at baseline. Doppler sonography showed normal flow parameters at both visits in 8 patients. No significant adverse events were recorded after the procedures, except for mild to moderate lumbar pain. Clinical data collected in this study seem to confirm chemical sympathesctomy as a reliable, effective and safe therapeutic option in ED secondary to CAY.

Adult↗
PubMedDate not supplied

Microsurgical distal sympathectomy in chronic vasospastic syndromes of the hand.

The authors propose a microsurgical technique to treat upper limb chronic digital ischemia that is resistant to medical therapy. The adventitiectomy technique on digital arteries is used here to remove the fibrous tissue and the vasoconstrictor sympathetic nervous fibers contained in it. This operation is a valid alternative to traditional proximal sympathectomy.

Adult↗
PubMed2006

[Application of minimally invasive lumbar sympathectomy in the treatment of patients with obliterating diseases of the lower extremity vessels].

The method of performance and immediate results of miniinvasive lumbar sympathectomy using retroperitoneal miniaccess were adduced in the work. In 2005 yr on the base of division of vascular surgery were operated 19 patients. Application of endoscopic instruments and optic system of illumination gave the possibility to remove lumbar sympathetic nodes in conditions of narrow (3-5 cm) surgical access and operative field. Introduction of miniinvasive method have promoted to reduce essentially the postoperative complications rate, the pain syndrome intensity, the reduction of duration of the patients postoperative rehabilitation, the cosmetic effect raising.

Adult↗
PubMed2006

A randomized trial of intravenous iloprost (a stable prostacyclin analogue) versus lumbar sympathectomy in the management of Buerger's disease.

AIM: The aim of this study was to compare the effects of iloprost and lumbar sympathectomy (LS) in the treatment of Buerger's disease. METHODS: Two hundred patients with rest pain and/or ischemic ulcers were randomized to undergo LS or 28-day intravenous treatment of iloprost. The primary endpoint was complete healing without pain or major amputation at 4 and 24 weeks. The secondary endpoints were analgesic requirement, reduction in the ulcer size, 50% reduction of the ulcer, and shift in the modified SVS/ISCVS clinical status grading scale. RESULTS: The comparison was carried out in 162 patients (iloprost: n=84; LS: n=78). Complete healing rate was 61.9% in the iloprost group, but 41% in the LS group at the 4th week (P=0.012); respective values for the 24th week were 85.3%, 52.3%, P<0.001. Analgesic requirement was lower in the iloprost group at the 4th and 24th weeks (P=0.01, and P=0.098, respectively). The size of the ulcers decreased more in the iloprost group than the LS group (P=0.044 and P=0.035 at 4th and 24th weeks); 50% reduction in the ulcer size in the iloprost group was greater than in the LS group (P=0.001 and P=0.009 at 4th and 24th weeks). SVS/ISCVS grading scale demonstrated a better clinical benefit in patients treated with iloprost (P<0.001 at 4th week, and P<0.001 and at 24th week). CONCLUSIONS: The results of this independent study indicate that using iloprost relieves ischemic symptoms better than LS. In the era of stable prostacyclin analogues, there is no reliable evidence to support the use of LS in Buerger's disease.

Adult↗
PubMed2006

[Upper-thoracic sympathectomy in the treatment of upper limb ischemia at distal form of arterial lesion].

Efficacy of upper-thoracic sympathectomies performed in 61 patients with chronic upper limb ischemia is analyzed. Thoracotomy was used in 20 cases, videothoracoscopic approach -- in 56 (including 15 cases of two-sided procedures). Efficacy was evaluated with clinical examination, rheovasography, laser Doppler-flowmetry, percutaneous detection of tissue oxygen tension. Advantages of videothoracoscopy compared with thoracotomy are demonstrated.

Adolescent↗
PubMed2006

Endoscopic thoracic sympathectomy by clamping in the treatment of social phobia: the Monza experience.

AIM: Facial blushing represents the peculiar symptom in social phobia and is defined as the ''hallmark of embarrassment''. At present, endoscopic thoracic sympathectomy (ETS) is the technique only able to guarantee long-term results in the treatment of sympathetic disorders. The aim of our study was to evaluate results, complications and the true value of 52 ETSs by two-port approach with the use of endoclips in patients with isolated facial blushing or in association with hyperhidrosis. METHODS: A retrospective review of 52 subjects who underwent standard ETS by clamping between September 2002 and April 2005 was carried out. This surgical practice was performed in 26 cases (50%) for isolated facial blushing only and in other 26 cases (50%) for facial blushing associated to hyperhidrosis with changeable localizations. Under endoscopic guidance we operated an endoscopic sympathetic block (ESB) with interruption of the inter-ganglion trunk at the level of T2-T3 in 51 patients (98.07%). In 1 patient (1.92%) we performed a sympathetic block with the complete exclusion of T3 thoracic ganglion. RESULTS: There were no intra and postoperative deaths. The effect rate was excellent in all patients with early complications in one patient (1.92%) only. CONCLUSIONS: ETS by clamping is safe and effective. Patients referred an high satisfaction in terms of complications and quality of life; specific early and late diseases are negligible.

Adult↗
PubMed1991

[Effects of dosed sympathectomy on the development of adaptation-compensation reaction of C-cells of the thyroid gland and chromaffin cells of the adrenal glands in young rats].

Using radioimmunological, morphometrical, electron microscopic and luminescent methods, comparative analysis of thyroid C-cells and adrenal chromaffin cells has been carried out at guanethidine sympathectomy in young rats. Significant decrease of functional activity of C-cells with concomitant hyperplasia of C-cells population under blockade of sympathetic influences has been revealed. Compared to C-cells, adrenal chromaffinocytes of sympathectomized rats possess higher degree of structural-functional mobilization and are characterized by intensive secretion of catecholamines directed at restoration of tissue neurotransmitter deficit.

Adrenal Glands↗
PubMed1991

Sympathectomy for wet, dripping palms.

An analysis of upper thoracic sympathectomy for palmar hyperhydrosis performed in a Neurological Department for the past ten years via several surgical approaches suggests that the posterior median approach is preferable. Histological confirmation of ganglion cells at time of surgery is recommended.

Adolescent↗
PubMed1991

Renal response to furosemide in conscious rats: effects of acute instrumentation and peripheral sympathectomy.

In order to investigate whether the renal sympathetic nerves contribute to the compensatory Na reabsorption observed during furosemide-induced volume contraction, furosemide was administered as constant i.v. infusion (7.5 mg/kg/h) in trained, chronically instrumented rats with or without guanethidine-induced peripheral sympathectomy. In addition, the effect of acute instrumentation was evaluated by measuring renal function before and after furosemide infusion in control rats recovering from surgery and halothane anesthesia. Lithium clearance was used as a marker for proximal tubular Na reabsorption, and [3H]inulin and [14C]tetraethylammonium were used as markers for the glomerular filtration rate and the effective renal plasma flow, respectively. Control values in chronically instrumented sympathectomized rats did not differ from values obtained in chronically instrumented control rats. In acutely instrumented control rats the control value for effective renal plasma flow was 20% lower than in both chronically instrumented groups; this was associated with increased arterial blood pressure and increased renal vascular resistance. There were no differences in the diuretic or the natriuretic furosemide response between chronically instrumented control and chronically instrumented sympathectomized rats, whereas the diuretic and natriuretic responses were reduced in acutely instrumented control rats. This was due to an accentuation of the initial fall in glomerular filtration rate during furosemide infusion. In control animals, either acutely or chronically instrumented, fractional Li excretion increased from 30% to 50% during furosemide peak response, after which it returned toward control values. In sympathectomized rats, the fractional Li excretion increased from 36% to 70% during furosemide peak response, after which it decreased to a steady-state value of 56%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

[Thoracic sympathectomy by thoracoscopy. Apropos of 15 cases].

Thoracic sympathectomy is generally performed by thoracotomy. Apart from the surgical approach, the thoracoscopic technique allows vision and physical or chemical destruction of the thoracic sympathetic system. We studied the possibilities of their technique. Thoracoscopy is performed under local anesthesia after creation of a pneumoserosa. Local anesthesia of the second sympathetic ganglion is performed. The ganglion is destroyed by injection of 8cc of phenol. Fifteen patients have been treated (15 to 70). The first five patients were failures and led to improvement of the technique. We have 8 good results. If we exclude the first five patients, we observe 8 good results and 2 failures. The thoracoscopic approach to the second sympathetic ganglion is not always possible (local pleurodesis). When it is possible, the results of local treatment by phenol are as good as those of surgery.

Adolescent↗
PubMed1990

[Effect of lumbar sympathectomy on late results of reconstructive operations on the abdominal aorta and arteries of the lower extremities].

The use of reconstructive operation in combination with lumbar sympathectomy for the treatment of obliterative lesion of the vessels of the aortoiliofemoral segment permits to reduce the incidence of development of the early postoperative vascular thrombosis and late reocclusion. A good patency of vascular transplants after combined operation was noted in 62% of cases, after isolated reconstruction--in 38%.

Aorta, Abdominal↗
PubMedDate not supplied

[Evaluation of the results of lumbar sympathectomy using hemodynamic variables].

In order to evaluate the results of the lumbar sympathectomy, we studied 49 patients in the National Institute of Angiology and Vascular Surgery during two years. The hemodynamic tests were performed the day before and one month after the surgical intervention; they included: skin thermometry, measurement of arterial blood flow and resistance in the foot and in the leg, and reactive hyperemia under photoplethysmographic control. Objectively, it could be seen only an increase in the distal skin temperature and an increase of skin blood flow after this treatment.

Evaluation Studies as Topic↗
PubMed1975

Sympathectomy revisited: Dodo or phoenix?

Personal experience with temporary or permanent interruption of adrenergic impulses to brain, heart, kidney, pancreas, and the extemities is reviewed and certain concepts which were formulated long ago are re-emphasized. First, adrenergic blockade unmasks the cholinergic activity of the autonomic nervous system. This is apparent particularly when cardiac, renal, or pancreatic functions are studied under stress. Second, in the immediate treatment of cerebral, cardiac, or digital ischemia, the potentially reversible halo of edema around the irreversible necrosis is rapidly influenced by ganglionic blockade. And third, attention is called to the effect of adrenergic stimulation on sensory nerve endings which develop a higher threshold for pain when sympathetic fibers are interrupted. Although potent drugs inhibiting alpha and beta receptors or the release of catecholamines are widely in use, the obvious advantages of regional vs. systemic interruption of adrenergic impulses is pointed out. When the latter approach is pursued aggressively, the side effects are those of a total sympathectomy.

Adrenal Glands↗
PubMed1987

Capsaicin-induced corneal lesions in mice and the effects of chemical sympathectomy.

Effects of chemical sympathectomy on corneal changes induced in mice by a s.c. injection of capsaicin were investigated. Pretreatment with a s.c. injection of 6-hydroxydopamine (6-OHDA) on the 1st and 2nd postnatal day or on the 14th and 15th postnatal day led to a marked suppression of the capsaicin-induced corneal lesions. This suppressive effect also was evident in case of administration after capsaicin treatment. Intraventricular injection of 6-OHDA had a slight, transient effect. DSP4 [N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine], another potent substance used for sympathetic denervation, had a suppressive effect similar to that of 6-OHDA. The concentration of capsaicin in tissues of the head was unaltered with 6-OHDA. The content of substance P (SP) in the ocular anterior segments was decreased, dose-dependently, with capsaicin administration. Neonatal administration of 6-OHDA decreased the rate of capsaicin-induced reduction of SP. However, this effect of 6-OHDA was too slight to explain the suppression of the corneal lesions, as the intensity score of lesions with a large dose of capsaicin after 6-OHDA was lower than that with a small dose of capsaicin without 6-OHDA, whereas SP content in the former was still much lower than that in the latter. On the other hand, the content of norepinephrine in the ocular tissues was decreased in the presence of 6-OHDA but not capsaicin. These results suggest that the corneal changes induced by capsaicin are largely inhibited by a decreased activity in the peripheral sympathetic system.

Animals↗
PubMed1989

Inability of chronic chemical sympathectomy to induce coronary collateral growth or development: studies in the rat heart in vivo.

The influence of chronic chemical sympathectomy on the extent of coronary collateral flow delivered to a zone of regional ischaemia following an acute coronary artery occlusion was examined in the rat. Male rats were randomly assigned to either 6-hydroxydopamine treated or vehicle treated groups (n = 20 in each group). Drug treated animals were injected with 6-hydroxydopamine intravenously as follows: day 1, 10 mg.kg-1; day 2, 50 mg.kg-1; days 7, 8, 14, 15, 21, 28, 35 and 42, 100 mg.kg-1. Control animals were injected in a similar manner with vehicle solution. On day 43, animals were anaesthetised, and their hearts were excised and perfused in the Langendorff mode at a perfusion pressure of 10 kPa. After 5 min the left main coronary artery was ligated and after a further 5 min, 153Gd labelled microspheres (10 microCi, 15 microns diameter) were infused via a side arm on the aortic cannula. This was followed within 3 min by the infusion of 3H-desmethylimipramine (5 microCi) via the same route. Disulphine blue dye was injected via the side arm within 1 min of the desmethylimipramine injection so as to delineate the perfused from the ischaemic region. The hearts were frozen in liquid nitrogen and freeze dried. The dried hearts were separated into ischaemic and non-ischaemic tissue on the basis of the blue dye coloration. The weighed samples were assessed for gamma and beta activity and the ratio of radioactive counts.g-1 in the ischaemic tissue to that of the non-ischaemic tissue was taken as an index of relative coronary collateral flow.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗