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.