Reardon P R, Matthews B D, Scarborough T K, Preciado A, Marti J L, Conklin L D, Garson A, Reardon M J
Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Smith Tower, 6550 Fannin #2435, Houston, TX 77030, USA.
Surg Endosc. 2000 Jan;14(1):86. doi: 10.1007/s004649901209. Epub 1999 Nov 25.
The long QT syndrome (LQTS) is a rare inherited cardiac disorder that may induce fatal cardiac arrhythmias. Patients diagnosed with this disorder generally have several treatment options, including beta-blockade, cardiac pacing, an implantable automatic defibrillator, or a high thoracic left sympathectomy. We report the case of a 6-year-old girl with the LQTS treated by left thoracoscopic sympathectomy and stellate ganglionectomy. The procedure was performed after an initial thorascopic attempt at another institution failed due to inadequate resection of the sympathetic chain. Operative time was 85 min and blood loss was minimal. There were no intraoperative or postoperative complications. The girl's QT interval decreased and she was discharged on the 4th postoperative day. After 9 months of follow-up, she remains asymptomatic. We conclude that the LQTS patients who fail medical treatment can be treated successfully with left thoracoscopic cervicothoracic sympathectomy. We recommend that the extent of sympathectomy for treating the LQTS be T1-T4 and either the entire stellate ganglion or at least the inferior one-third.
长QT综合征（LQTS）是一种罕见的遗传性心脏疾病，可能诱发致命性心律失常。被诊断为此疾病的患者通常有多种治疗选择，包括β受体阻滞剂、心脏起搏、植入式自动除颤器或高位胸段左侧交感神经切除术。我们报告一例6岁患长QT综合征的女孩，经左胸交感神经切除术和星状神经节切除术治疗。该手术是在另一家机构最初的胸腔镜手术尝试因交感神经链切除不充分而失败后进行的。手术时间为85分钟，失血极少。术中及术后均无并发症。女孩的QT间期缩短，术后第4天出院。经过9个月的随访，她仍无症状。我们得出结论，药物治疗无效的长QT综合征患者可通过左胸颈胸交感神经切除术成功治疗。我们建议，治疗长QT综合征的交感神经切除术范围为T1 - T4，切除整个星状神经节或至少下三分之一。
