J.Jpn. Surg. Soc.. 59(13): 1941-1989, 1959
CLINICAL STUDIES ON THE SURGERY OF SYMPATHETIC NERVES FOR DISORDERS OF THE PERIPHERAL ARTERIES
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II. Department of Surgery, Tokyo University School of Medicine (Chief: Prof. Seiji KIMOTO) Koichi ASO |
1) A series of tests devised by the author, namely, Imidalin Thermic Test, Adrenalin Thermic Test and Thermoradiation Test are simple to perform and each test has its own significance. They are very helpful to discover the disturbance of peripheral circulation and to differenciate the organic vascular obstruction from the functional vascular spasm, and furthermore, they are very useful for the decision of the indication for a sympathectomy and for the judgement of its prognosis.
2) As to the operative procedure for the lower extremities, the second and the third lumber sympathectomy is performed as a rule, and after the clinical course is observed, higher sympathectomy is added for a patient with poor resuit. For the upper extremities, the second and the third thoracic sympathectomy is performed as a rule and sometimes the fourth thoracic sympathectomy is also performed. It is thought to be safe to preserve the stellate ganglion.
3) The long term observation of the obstructive disorders revealed that the treatment was effective on 22 cases out of 29 cases (75.8%), while for Raynaud's disease, it was effective only for one out of four cases although only a few cases were observed. It cannot be necessarily affirmed that the satisfactory result has been obtained for Raynaud's disease.
4) Disturbed sexual function was noted on 5 cases out of 34 cases with various kinds of sympathectomy. They are all male patients and had bilateral lumber sympathectomy, however, it cannot be concluded that the phenomenon is frequently caused only by the first lumber sympathectomy as has been stated up to now.
(author's abstract)
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