Guérin J C, Demolombe S, Brudon J R
Clinique de Pneumo-phtisiologie, Hôpital de la Croix-Rousse, Lyon.
Ann Chir. 1990;44(3):236-8.
Thoracic sympathectomy is generally performed by thoracotomy. Apart from the surgical approach, the thoracoscopic technique allows vision and physical or chemical destruction of the thoracic sympathetic system. We studied the possibilities of their technique. Thoracoscopy is performed under local anesthesia after creation of a pneumoserosa. Local anesthesia of the second sympathetic ganglion is performed. The ganglion is destroyed by injection of 8cc of phenol. Fifteen patients have been treated (15 to 70). The first five patients were failures and led to improvement of the technique. We have 8 good results. If we exclude the first five patients, we observe 8 good results and 2 failures. The thoracoscopic approach to the second sympathetic ganglion is not always possible (local pleurodesis). When it is possible, the results of local treatment by phenol are as good as those of surgery.