Thoracoscopic Sympathectomy for Raynaud's Phenomenon—A Long Term Follow-up Study

ObjectivesTo assess the long term results of thoracoscopic sympathectomy for Raynaud's phenomenon.Design, materials and methodsA retrospective study of 34 consecutive patients who were treated for Raynaud's phenomenon by thoracoscopic sympathectomy from 1996 to 2005. Eight patients presented with ulcerations of the digits and 10 had severe ischaemia without ulcerations. The hospital records were retrieved and questionnaires were mailed to the patients for follow-up.ResultsThe questionnaire was answered by 91% of patients after a median follow-up time of 40 months. An immediate effect was seen in 83% of the patients but symptoms recurred in 60% during the follow-up period. Compensatory sweating occurred in 63 and 30% reported gustatory sweating. Thirteen patients (43%) regretted having the operation.ConclusionThe majority of patients with Raynaud's phenomenon have an excellent immediate effect from thoracoscopic sympathectomy and one third achieve a long lasting effect. Side effects are frequent. We now only use thoracoscopic sympathectomy in severe cases of Raynaud's phenomenon.