Endoscopic thoracic sympathecotomy for Morbus Raynaud's phenomenon (Mansoura University Hospital experience)

Background Endoscopic thoracic sympathecotomy (ETS) is used for the treatment of a wide range of upper limb disorders. The aim of this study was to represent our experience with ETS as a minimally invasive procedure in the treatment of Morbus Raynaud's phenomenon (RP). Patients and methods From January 2012 to March 2015, 29 patients complaining of Morbus RP underwent ETS in the Vascular Surgery Department, Mansoura University Hospital. Eleven patients (38%) presented with digital ulceration despite intensive medical therapy, and 18 patients (62%) presented with severe ischemia without ulceration. Results Twenty-nine patients were subjected to 58 ETS. There were eight male (27.55%) and 21 female patients (72.5%) with a mean age of 38 years (range 21-67 years). The mean operative time was 30 ΁ 6 min (range 22-45 min). There were no deaths or major intraoperative complications. Initial improvement of symptoms with ulcer healing was achieved in 28 of 29 patients (96.5%). Recurrence of the symptoms occurred in 15 patients (52%); however, the symptoms were less severe compared with preoperative symptoms. There was no recurrence of digital ulceration. Conclusion ETS for RP has good initial effect despite a high rate of recurrence. However, the symptoms were less severe compared with preoperative symptoms and without recurrence of digital ulceration. ETS is a preferred treatment modality for Morbus RP.