Percutaneous Thermocoagulation Radiofrequency Upper Thoracic Ganglionectomy and Sympathectomy

摘要

Background: Sympathectomy is the surgery of choice for treatment of bothersome hyperhidrosis. Much less frequent indications are complex regional pain syndrome (CRPS), ischemic conditions including peripheral vascular disease and pain of malignant origin. Objective: To describe the technique, complications of percutaneous thermocoagulation radiofrequency upper thoracic ganglionectomy and sympathectomy. We aim to evaluate the outcome, safety, efficacy of this technique. Methods: From September 2007 to May 2010, upper thoracic ganglionectomy and sympathectomy were performed in 80 patients with palmar and craniofacial hyperhidrosis, 20 patients with complex regional pain syndrome. Results: After initial thermocoagulation, sweating stopped in 98.2% of patients, while 1.8% experienced hypohidrosis, while in CRPS all patients had satisfactory pain relief up to 24 months follow up. The mean Visual Analogue Scale for pain decreased from 7.5 in the preoperative period to the mean value of 1.75 in the postoperative period. Complications in our study were mild, transient without permanent or serious complications. Conclusion: The results of this study indicate that upper thoracic ganglionectomy and sympathectomy performed with the use of percutaneous thermocoagulation are a very effective treatment that provides excellent immediate and long-term results as well as a low complication rate. The method is also effective as a retreatment for recurrences. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(1): 73-80]