Bilateral thoracoscopic splanchnicectomy with sympathectomy for managing abdominal pain in cancer patients.

作者信息

Kang Chang Moo, Lee Hye Yeon, Yang Hee Jun, Jang Han Jung, Gil Young Chun, Kim Kyung Sik, Choi Jin Sub, Lee Woo Jung, Kim Byong Ro

机构信息

Department of Surgery, Yonsei University College of Medicine, 250 Seongsanno (134 Shinchon-dong), Seodaemun-gu, Seoul, Korea, 120-752.

出版信息

Am J Surg. 2007 Jul;194(1):23-9. doi: 10.1016/j.amjsurg.2006.11.018.

DOI:10.1016/j.amjsurg.2006.11.018

PMID:17560904

Abstract

BACKGROUND

Simple interruption of splanchnic nerve can lead to incomplete transection of nerve fibers responsible for cancer-derived abdominal visceral because lots of neural communications exist.

METHODS

From December 1999 to June 2005, a total of 21 cancer patients underwent bilateral thoracoscopic segmental resection of splanchnic nerve with sympathectomy for intractable abdominal pain based on the anatomic observation of 26 embalmed Korean cadaveric specimens in Yonsei University Medical Center, Seoul, Korea. All patients were preoperatively asked to rate the extent of their current pain by using the numeric rating scale (NRS), where 0 indicated no pain and 10 indicated intractable pain. The effectiveness of this thoracoscopic procedure was assessed based on the NRS reevaluated after surgery.

RESULTS

NRS score was significantly reduced after thoracoscopic surgery (1.71 +/- 1.10 versus 8.52 +/- 1.08, paired t test, P < .0001). Sixteen patients (76.2%) could tolerate pain without or with reduced dose of analgesics. No mortality and morbidity were found in this study.

CONCLUSION

This bilateral thoracoscopic splanchnicectomy with sympathectomy is safe, easy, and effective method in managing cancer-derived visceral abdominal pain.

摘要