OBJECTIVE
The purpose of the study is evaluation of results of thoracoscopic sympathetic-splanchnicectomy to relive a pain syndrome in cases of unresectable abdomen tumors and chronic pancreatitis
MATERIAL AND METHODS
During 2006-2019 years thoracoscopic sympathetic-splanchnicectomy was performed in 32 cases of unresectable abdomen tumor and chronic pancreatitis with severe pain syndrome. We present a retrospective analysis of treating of 24 men and 8 women, mean rage 53.62 (age range 40-75 years). Bilateral thoracoscopic sympathetic-splanchnicectomy was performed in all cases. All interventions were performed under general anesthesia with separate lung intubation. In most cases (26 patients), we used single port access. Two patients were operated via double port access, four patients — three-port access. Chest tube was not placed in 28 (87.5%) cases.
RESULTS
The duration of surgical intervention ranged from 20 to 85 (average 58.7±10.2) minutes. There were not complication during operation time. We did not notice difference between operation time and number of ports. In post operation time, chest tube was placed in one cases because of right pneumothorax. The subcutaneous emphysema without pneumothorax was found in one case. In all cases of bilateral intervention, the surgery was 100% successful. A comparative evaluation of the pain syndrome intensity by using a visual analogue scale in the pre- and postoperative period showed a statistically significant decrease from 8.9±1.1 before surgery to 3.0±1.2 after surgery (p=0.003). All patients were discharged from the hospital on the 3rd-4th days after surgery. There were not post-surgery complications in all cases. There was no need for repeated interventions with bilateral operation.
CONCLUSION
Bilateral thoracoscopic sympathetic-splanchnicectomy is high efficiencies intervention. It has a low incidence of intraoperative and postoperative complications for the pain relief in patients with unresectable abdomen tumor and chronic pancreatitis. Bilateral intervention can be performed through one port at once without technical difficulties and can be recommended as the method of choice for relieving chronic pain syndrome in patients with unresectable abdomen tumor and chronic pancreatitis.
