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 127 records · Page 7Linked to original sources
PubMed1988

The effect of lumbar sympathectomy on postsynaptic vascular smooth muscle response in the lower limb in dogs.

The intent of this experiment was to study the postsynaptic vasoactive response to tolazoline hydrochloride and sodium-meglumine diatrizoate (Renografin-76) after a unilateral lumbar sympathectomy in a dog model. Both lower extremities were examined using the video dilution technique before and 1-2 weeks after unilateral lumbar sympathectomy (SE). Results showed (1) resting blood flow in the femoral artery as a percentage of cardiac output did not change after sympathectomy (mean and SD before and after SE: 7.0% +/- 2.3 and 6.0% +/- 2.9 respectively n = 13); (2) the reactive hyperemia in the femoral artery caused by sodium-meglumine diatrizoate (Renografin-76) was unchanged after sympathectomy; (3) the vasodilator effect of tolazoline hydrochloride decreased significantly after sympathectomy (p less than 0.05).

Animals↗
PubMed2005

Effects of lumbar sympathectomy on pain behavioral changes caused by nucleus pulposus-induced spinal nerve damage in rats.

It has been suggested that lumbar sympathectomy can reduce pain behavior, including mechanical allodynia and thermal hyperalgesia, caused by ligation of the spinal nerve. One well-characterized model, which involves application of nucleus pulposus to the spinal nerve and displacement of the adjacent nerve, shows behavioral changes in rats. However, there have been no previous reports regarding sympathectomy performed in this model. Disk incision and adjacent spinal nerve displacement were performed with (n=6) or without (n=6) sympathectomy. Sham surgery was also performed with (n=6) or without (n=6) sympathectomy. The animals were tested for 3 days before surgery and on days 1, 3, 7, 14, and 21 after surgery. Non-noxious mechanical thresholds were tested by determining the hind paw withdrawal response to von Frey hair stimulation of the plantar surface of the footpad using a touch stimulator. Thermal nociceptive thresholds were tested using a sensitive thermal-testing device. While rats in the disk incision with displacement surgery group showed allodynia and hyperalgesia after surgery on the experimental side, sympathectomized animals did not. No allodynia was observed in the sham groups. Sympathectomy seemed to prevent the pain behavioral changes caused by the combination of disk incision and nerve displacement.

Animals↗
PubMed1993

Dorsal sympathectomy and management of thoracic outlet syndrome with VATS.

Dorsal sympathectomy and the management of the thoracic outlet syndrome have been considerably improved with the use of video assistance because it affords both magnification and an improved light system. Two techniques of video assistance were employed in the group of patients described here. One involved the sympathectomy done through three ports using standard video-assisted thoracic surgical methods. The second technique involved a transaxillary incision with removal of the first rib using video-assistance magnification and light, operating either directly or secondarily while visualizing the image on the television set. (The vast majority of cases have been performed using this latter technique.) Major indications for performing dorsal sympathectomy include (1) hyperhidrosis, (2) Raynaud's phenomenon, (3) Raynaud's disease, (4) causalgia, (5) reflex sympathetic dystrophy, and (6) vascular insufficiency of the upper extremity. Except for hyperhidrosis, all of the other indications require the usual diagnostic techniques, including cervical sympathetic blockade to assess whether the symptoms are relieved by temporary blockade of the sympathetic ganglia. In 326 patients, sympathectomy, performed either alone or in conjunction with first-rib removal for relief of the thoracic outlet syndrome, has been successful. In only 6 patients has sympathetic activity recurred in less than 6 months. Initially all of them were treated conservatively. Three of the 6 required a repeat sympathectomy. Postsympathectomy neuralgia occurred in only 2 of more than 326 patients. Both cases were managed successfully in a conservative fashion. Among the patients in whom a Horner's syndrome was not deliberately induced, the syndrome developed in 2. In both, the syndrome resolved spontaneously within several months.

Autonomic Nervous System Diseases↗
PubMed1987

Differential effects of surgical sympathectomy on rat heart concentrations of neuropeptide Y-immunoreactivity and noradrenaline.

The aim of this study was to estimate the proportion of cardiac neuropeptide Y-immunoreactivity (NPY-ir) which is not present in sympathetic neurones innervating the rat heart. The procedure employed was to surgically sympathectomize the heart and then measure the remaining cardiac concentrations of NPY-ir and noradrenaline (NA). Unilateral (left) sympathectomy significantly reduced the levels of NPY-ir and NA in all regions of the heart (by 40-70%) except for the NPY-ir in the right atrium which was unaltered. The effect of bilateral sympathectomy was significantly greater than that of unilateral sympathectomy. Unilateral and bilateral sympathectomy produced similar reductions in the concentrations of NPY-ir and NA in the ventricular tissue. In contrast dissimilar changes were produced in the atrium. Although bilateral sympathectomy almost totally depleted the NA from the right atrium (by 98%), the NPY-ir levels were only reduced by 50%. These results indicate that approximately half the content of NPY in the right atrium is not present in sympathetic noradrenergic neurones. This pool may occur in the previously described intrinsic neurones of the right atrium.

Animals↗
PubMed1991

Sympathectomy alleviates mechanical allodynia in an experimental animal model for neuropathy in the rat.

We attempted to determine the effects of surgical sympathectomy on an animal model for neuropathic pain. The L5 and L6 spinal nerves on one side were tightly ligated in anesthetized rats. Mechanical sensitivity of the affected hind paw was significantly elevated from the first day after the surgery as evidenced by the increased occurrence of foot withdrawal to innocuous mechanical stimulation applied with von Frey filaments to the hind paw. The increased mechanical sensitivity continued for three weeks, at which time surgical sympathectomy was performed by removing the L2-L6 sympathetic chain. The sympathectomy produced an immediate and almost complete reversal of the increased mechanical sensitivity, whereas sham sympathectomy had no effect. The data suggest that sympathectomy alleviates mechanical allodynia in this experimental animal model.

Animals↗
PubMed1991

Effects of sympathectomy in a model of causalgiform pain produced by partial sciatic nerve injury in rats.

In a previous report we presented a novel behavioral model of neuropathic pain disorders, produced in rat by a unilateral ligation of about half of the sciatic nerve. The model is characterized by rapid onset of behaviors suggesting spontaneous pain and disordered responses to non-noxious and noxious stimuli. These include reduced withdrawal thresholds to repetitive touch in the partially deafferented skin ('touched-evoked hyperesthesia'), touch-evoked allodynia, reduced withdrawal thresholds to noxious thermal stimuli and exaggerated responses to noxious heat and mechanical stimuli ('thermal hyperalgesia'). Some of these disorders are seen at mirror image sites on the hind limb opposite the lesion. These disorder start within hours after partial nerve injury, last many months and are very similar to causalgia in humans following partial nerve injury. Since sympathetic efferent activity is known to aggravate causalgia in humans and sympathectomy is known to relieve it, we studied the effect of changing sympathetic outflow in the rat model. Reversible sympathectomy was carried out using guanethidine injected intraperitoneally in 3 experiments, each at a different time in relation to the partial nerve injury. We found that: (1) sympathectomy performed several months postoperatively alleviated the sensory disorders bilaterally; (2) sympathectomy prior to nerve injury partially prevented the appearance of thermal hyperalgesia but did not affect hyperesthesia to repetitive touch; and (3) sympathectomy at the time of nerve injury aggravated the sensory disorders during the first few days. As maintenance and production of the sensory disorders in this animal model depended on sympathetic nervous outflow, we conclude that the rats were suffering from a syndrome analogous to sympathetically maintained causalgia in man.

Animals↗
PubMed1994

Thoracoscopic cervicodorsal sympathectomy: preliminary results.

PURPOSE: The purpose of this study was to determine the feasibility, safety, and efficacy of thoracoscopic cervicodorsal sympathectomy. METHODS: From March 1990 to December 1993, we performed 21 thoracoscopic sympathectomies in 19 patients. There were 13 women and six men; age 17 to 64 years, mean 37 years. Thirteen procedures were performed on the left side and eight on the right. Indications for surgery were causalgia/reflex sympathetic dystrophy in nine patients, Raynaud's/vasculitis in six, hyperhidrosis in five, and medically refractory cardiac arrhythmia in one. RESULTS: The T1-4 sympathetic ganglia were readily identified, dissected free, and resected thoracoscopically in 19 cases, and the T3-7 ganglia were resected with thoracoscopy in one case. One case required conversion to an open thoracotomy because of dense scar from a previous first rib resection, which obscured the anatomy. Histologic confirmation of ganglia were obtained in all 21 cases. Operative duration ranged from 1.0 to 3.5 hours. Estimated blood loss was 5 to 300 cc, mean 42 cc, median 10 cc. No patient required transfusion. All 21 patients had an excellent immediate sympathectomy response. Transient Horner's syndrome developed in two patients. Postoperative residual pneumothorax (< 10%) occurred in three cases and resolved spontaneously without further treatment. In one patient pleural effusion and pneumothorax developed, which were treated with the reinsertion of the chest tube. Postoperative pain was well controlled with oral analgesics. Hospital stay was 1 to 4 days, mean 2 days, median 1 day. Follow-up at 1 to 42 months, mean 11 months, median 6 months, showed continued evidence of sympathectomy effect in all patients, except one who died of her underlying disease 1 month after operation. CONCLUSIONS: We conclude that thoracoscopic sympathectomy is feasible, safe, and effective. Further studies are indicated to confirm its long-term benefits and to determine optimal thoracoscopic techniques.

Adolescent↗
PubMed2004

Upper thoracic sympathectomy for axillary osmidrosis or bromidrosis.

The difference between axillary osmidrosis (AO) and axillary bromidrosis (AB) is the degree of odor and quantity of sweat, which is associated with selection of therapeutic modality theoretically. Upper thoracic sympathectomy has been used for both diseases but its effect needs to be further evaluated with more clinical data. We collected 108 patients with AO or AB treated by upper thoracic sympathectomy from July 1995 to July 2002. Of these patients, 42 suffered AO alone, 17 had AB (AO with axillary hyperhidrosis [AH]), and 49 had AO with palmar hyperhidrosis (PH). Ninety-two patients (183 sides) received anterior subaxillary transthoracic endoscopic sympathectomy (TES) and 17 patients (33 sides) received posterior percutaneous thoracic phenol sympathicolysis (PTPS). The levels of sympathectomy or sympathicolysis were T3-4 for AO and AB, and T2-4 for AO with PH. Mean follow-up period was 45.2 months (13-97 months). The satisfaction rates of patients were 52.4%, 70.6% and 61.2% for AO, AB and AO with PH, respectively. The rates of patients with improvement and satisfaction were 78.6%, 88.2% and 85.7% for AO, AB, and AO with PH, respectively. These results suggest that upper thoracic sympathectomy may be an acceptable treatment for AB or AO with PH rather than AO only.

Adolescent↗
PubMed1997

Intraoperative monitoring of skin temperature changes of hands before, during, and after endoscopic thoracic sympathectomy: using infrared thermograph and thermometer for measurement.

OBJECTIVE: To investigate the roles of the second and third thoracic spinal segments in the preganglionic sympathetic innervation of the hand, and to compare skin temperature changes between thenar and other parts of palm before, during, and after endoscopic thoracic sympathectomy. DESIGN: Twelve patients, four women and eight men, with severe palmar hyperhydrosis underwent endoscopic thoracic sympathectomy. The T3 segment was identified and dissected first, followed by T2 segment extirpation. Skin temperature changes of the hand were assessed by thermograph and thermometer simultaneously before, during, and after sympathectomy. Sympathetic skin responses were undertaken 1 day preoperatively and followed up 6 months postoperatively. SETTING: An electrophysiological laboratory and operating room in a national medical center. SUBJECTS: Twelve patients who sustained a profound degree of palmar hyperhydrosis. INTERVENTIONS: Skin temperature differences of the hands were measured by infrared thermograph and thermometer before, during, and after endoscopic thoracic sympathectomy. MAIN OUTCOME MEASURES: Group's average temperature differences, and sympathetic skin response (all or none response). RESULTS: The T2 spinal segment is thought to be the main source of sympathetic outflow to the sweat glands of the hand. The group's average temperature changes were significantly higher at the 2nd through 5th fingers' tips than at the thenar after completion of T2 extirpation (p < .005). CONCLUSIONS: Intraoperative monitoring of palmar skin temperature, as judiciously measured by infrared thermograph, yields useful information about the locations of the sympathetic segments and confirmation of their entire ablation by endoscopic thoracic sympathectomy.

Adolescent↗
PubMed1994

Acetylcholine sweat test: an effective way to select patients for lumbar sympathectomy.

Although lumbar sympathectomy can benefit patients with critical limb ischaemia, many derive no benefit from the procedure. The poor prediction of outcome may be related to pre-existing damage to the sympathetic fibres. We assessed sympathetic nerve function with the acetylcholine sweatspot test before and after lumbar sympathectomy in 31 patients with critical limb ischaemia. Of 9 patients with normal sympathetic function or minor denervation preoperatively (sweatspot score > or = 8), 8 showed improvement in pain and/or healing of ischaemic lesions after sympathectomy. The procedure did not achieve denervation in the patient without improvement, as shown by persisting sympathetic activity postoperatively. By contrast, among the 22 patients with lower sweatspot scores, indicating severe or complete sympathetic denervation, only 1 showed improvement (partial) after lumbar sympathectomy. 9 patients underwent oximetry before and after the operation; in this subgroup there was a positive correlation between preoperative sweatspot score and the change in tissue partial pressure of oxygen (r2 = 0.35). Preoperative assessment of sympathetic nerve function by means of a sensitive, quantitative test of autonomic integrity can predict the outcome of the procedure with high sensitivity and specificity. A postoperative test allows verification of sympathetic denervation. We recommend use of this simple test in selecting patients for lumbar sympathectomy.

Acetylcholine↗
PubMed1994

The role of sympathectomy in current surgical practice.

Historically sympathectomy has been employed in the treatment of a variety of disparate disorders but in most there is little if any objective clinical evidence of its efficacy. Review of the literature confirms that sympathectomy provides an effective and permanent cure for hyperhidrosis of the hands and feet, and at present palmar hyperhidrosis is the major indication for its regular use. Sympathetic denervation of the hands is currently most easily achieved with minimal morbidity by thoracoscopic ablation of the second thoracic ganglion. Some evidence testifies to the efficacy of sympathectomy in the rare patients with true major causalgia. Clinical experience suggests that Raynaud's phenomenon in the feet can be usefully ameliorated by sympathectomy but in the hands any benefit is short lived and there is no effect on the prognosis of the disease. A weak case can be made for sympathectomy for ischaemic rest pain when arterial surgery is impractical but there is no reliable evidence to support its use in Buerger's disease, intermittent claudication, diabetic vascular disease or ischaemic ulceration or gangrene.

Causalgia↗
PubMed1997

Morphometric changes seen in balloon-injured porcine iliac arteries: the influence of sympathectomy on intimal hyperplasia and remodelling.

OBJECTIVES: To assess the influence of lumbar sympathectomy on intimal thickening and arterial remodelling following balloon de-endothelialisation. DESIGN: Experimental animal model with control and treated (sympathectomy) groups. METHODS: Unilateral common iliac artery de-endothelialisation was performed in 36 male pigs using a 5F balloon catheter introduced via the profunda femoris artery. Bilateral lumbar sympathectomies were performed in 18 animals. Both iliac arteries were perfusion-fixed and harvested 4 weeks later. Arterial morphometry was assessed using computer image analysis. RESULTS: Area measurements are expressed as median (interquartile range) in mm2. Balloon injury resulted in significant intimal thickening but no loss of lumen due to compensatory enlargement of the injured artery. Sympathectomy resulted in significant lumen enlargement (4.8 (2.6-6.3) vs. 1.9 (1.7-2.9)) in balloon-injured arteries. Although intimal thickening was reduced (0.9 (0.6-1.7) vs. 1.5 (0.9-2.0)), this was not statistically significant. CONCLUSIONS: Sympathectomy increases lumen area 4 weeks after balloon injury to porcine iliac arteries. This effect is due to a combination of reduced arterial wall thickening and increased arterial size.

Angioplasty, Balloon↗
PubMed2006

[Results of high bilateral endoscopic thoracic sympathectomy and sympatholysis in the treatment of primary hyperhidrosis: a study of 1016 procedures].

OBJECTIVE: Thoracic sympatholysis and sympathectomy are the current standard treatments for primary hyperhidrosis. In this study, we evaluated the incidence of peri- and postoperative complications associated with these procedures. PATIENTS AND METHODS: From 1996 to 2004, 520 consecutive patients (364 women), with a mean age of 26.8 years, were treated for primary hyperhidrosis at our hospital. The procedure was bilateral in all but 24 cases. The 484 patients in the sympatholysis group underwent a single intervention while the 36 patients in the sympathectomy group underwent 2 separate interventions. RESULTS: No deaths occurred. Anhidrosis of the target area was achieved in 97.6% of patients while 2.2% experienced hypohidrosis. In 0.2% of the cases, the procedure was initially unsuccessful and a second intervention was required. The mean duration of hospital stay was 72 hours for patients in the sympathectomy group and 17 hours for the sympatholysis group. Serious intraoperative complications requiring conversion to thoracotomy were recorded in 0.2% of patients. Postoperative complications--of which pneumothorax was the most common--occurred in 5.2% of the cases (in 22.5% of the sympathectomy group and 3.55% of the sympatholysis group). Compensatory hyperhidrosis occurred in 48.4% of the patients, excessive dryness of the hands and palpebral ptosis in 0.38%, and gustatory sweating in 0.9%. The degree of patient satisfaction was quite high (88.5%) and only 2.3% were very unsatisfied. CONCLUSIONS: Given the results obtained, we can conclude that both sympatholysis and sympathectomy are appropriate treatments for hyperhidrosis. Nonetheless, because sympatholysis is both easier to perform and less aggressive, we consider it the treatment of choice for primary hyperhidrosis.

Adolescent↗
PubMed2000

[The indications for and results of video thoracoscopic sympathectomy].

BACKGROUND AND OBJECTIVES: Thoracoscopic sympathectomy, for years an effective way to treat mainly palmar and axilla hyperhidrosis, experienced a revival since the application of the principles of minimally invasive surgery. We report the personal experiences of three surgeons with this technique, as well as patients' view of the outcome. PATIENTS AND METHODS: Between January 1990 and November 1997, 73 procedures were performed in 43 patients (23 males, 20 females, mean age 38.1 years, range 15-82 years), and the outcome was prospectively studied. Palmar hyperhidrosis without axilla symptoms was the indication for the operation in 27 patients (54 sympathectomies), Raynaud's syndrome in 15 (18 sympathectomies), and causalgia in one. Thoracic ganglia 2-4 were always completely resected. Perioperative morbidity as well as patient satisfaction in the long-term course (standardized interview) 25.8 (1-77) months postoperatively were assessed. RESULTS: The complication rate in all 73 sympathectomies was 8.2%. Only two severe incidents were observed: in one patient intermittent Horner's syndrome (1.4%) occurred, and in another severe bleeding required conversion to open surgery (1.4%). Both complications occurred in the early study phase. The initial success rate in all 27 patients with hyperhidrosis was 100%. In 30% of these cases a mild partial relapse was observed, which did not interfere with their daily activities. 53% of the patients reported compensatory and 23% gustatory sweating. 9% would have refused the operation, had they known these side effects. In all patients with Raynaud's disease the ulcerations healed completely. At the time of the interview, two patients (13%) complained of painless relapses. They too stated that they had refused the operation, if they had known about the relapses. CONCLUSIONS: Even in the longer-term course, thoracoscopic sympathectomy is rated subjectively successful by 93% of patients after treatment of hyperhidrosis of the upper extremities, and by 87% of patients after treatment of Raynaud's disease, despite some untoward effects and partial relapses.

Adolescent↗
PubMed1996

An anatomic study of neuropeptide immunoreactivities in the lumbar dura mater after lumbar sympathectomy.

STUDY DESIGN: The distribution and density of nerve innervation in the lumbar dura mater after lumbar sympathectomy were assessed in wistar rats. OBJECTIVE: To provide basic information on the interaction between sympathetic and sensory nerves in patients with low back pain. SUMMARY OF BACKGROUND DATA: Many studies have indicated that the sinuvertebral nerve has an important role in innervating the tissues around the vertebrae. However, the origin, innervating pattern, and connections between the nerves are still controversial. It is well known that pain is often accompanied with sympathetic symptoms and exaggerated by sympathetic stimuli. Occasionally, anesthetic block at the L2 or L3 sympathetic ganglion relieves low back pain or symptoms associated with low back pain. The authors assessed the changes of the density and distribution of nerve innervation of the lumbar dura mater after lumbar sympathectomy. METHODS: Normal adult rats were sympathectomized at L2-L3. The threshold for thermal noxious pain by hot-plate analgesia test and changes in neuropeptides in the lumbar dura mater and dorsal root ganglia using light microscopic immunohistochemistry were assessed and compared with control rats. RESULTS: In the hot-plate analgesia test, sympathectomized rats increased their hot-plate latency time compared with that of sham-operated rats. Density of calcitonin gene-related peptide immunoreactive fibers in sympathectomy side of the lumbar dura mater decreased to 45.5% compared with the contralateral side. The number and size of calcitonin gene-related peptide immunoreactive cells in dorsal root ganglia showed no difference between sympathectomized and contralateral side. CONCLUSION: Sympathectomy increased the pain threshold and made the sympathectomized rats hypesthetic. A large numbers of sensory fibers innervated the lumbar dura mater via L2-L3 sympathetic nerve in rats. Sympathectomy reduced the number of these nerve fibers in the lumbar dura mater. Sympathetic nerves may play an important role for low back pain involving the lumbar dura mater.

Animals↗
PubMed2006

Horner syndrome after sympathectomy in the thoracoscopic era.

OBJECTIVE: Horner syndrome after sympathectomy has significantly decreased in current surgical practice. This is predominantly due to refinements in operative techniques, and an improved understanding of the patterns of sympathetic outflow pathways. We present a review of our experience with this disconcerting complication of sympathectomy when undertaken for palmar hyperhidrosis. METHODS AND TECHNIQUE: Over a 12-year period (1992 to 2004), patients undergoing sympathectomy for palmar hyperhidrosis were prospectively evaluated. In all patients the thoracoscopic approach was attempted bilaterally. The technique entailed the accurate identification of the second thoracic ganglion, followed by its dissection and resection. Excessive manipulation and cautery on the sympathetic chain was avoided. RESULTS: A total of 1137 procedures were undertaken in 567 patients. In 1 patient (during the early part of the technical experience) a unilateral Horner syndrome was noted on the first postoperative day; this effect was noted to have resolved spontaneously within 6 months. Review at 3 months was possible in 382 patients, either directly or telephonically. In these patients no further case of Horner syndrome was documented. CONCLUSIONS: The key to avoiding the development of a Horner syndrome after sympathectomy entails a thorough appreciation of the appropriate surgical anatomy, avoidance of violent manipulation and traction of the sympathetic chain, and the avoidance of diathermy on the sympathetic chain. The adherence to these principles has consigned Horner syndrome after sympathectomy as an entity of historical interest.

Horner Syndrome↗
PubMed2004

Lumbar sympathectomy increases blood flow in a dog model of chronic cauda equina compression.

OBJECTIVE: This study was designed to assess changes in blood flow of the dog cauda equina after lumbar sympathectomy using an experimental chronic cauda compression model. METHODS: The cauda equina was compressed at 10 mm Hg with a plastic balloon in all animals (n = 12). One week later, bilateral lumbar sympathectomy was carried out in the LSX group (n = 7), and vessels of the cauda equina were thereafter observed for 90 minutes using a specially designed microscope supplied with a video camera. Five animals did not undergo sympathectomy and were used as controls. The volume of blood flow was calculated from two parameters: velocity (mm/s) and diameter (microm) of a vessel observed in each animal. RESULTS: The increment in vessel diameter in the LSX group was pronounced at 30 and 45 minutes after sympathectomy compared with the control group (P < 0.05). Blood flow in the LSX group was increased at 30 minutes depending on dilation of the vessel diameter compared with the control group (P < 0.05). The velocity in the observed vessels remained unchanged throughout the measurements. CONCLUSIONS: These data suggest that lumbar sympathectomy could induce an increase in blood flow of the compressed cauda equina. As lumbar sympathetic block increases blood flow not only in the lower limbs but also in the cauda equina, it might be evaluated for a conservative treatment of intermittent claudication due to lumbar spinal canal stenosis.

Animals↗
PubMed1976

Chemical lumbar sympathectomy.

The technique of injection and the results of a series of 124 chemical lumbar sympathectomies, performed on 97 patients, are described. Sixty-eight patients, over 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Fifty-two of these patients benefited in terms of pain relief and only one required amputation. Sixteen patients, under 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Ten of these patients benefited but it is recommended that, where possible, other methods of treatment should be used in this younger age group. Thirteen patients, mostly elderly, had their sympathectomy because of diabetic ischaemic disease. Six only of these patients benefited, but it is felt that chemical sympathectomy can be recommended as a way of helping some of these patients who would otherwise have amputation.

Age Factors↗