J.Jpn. Surg. Soc.. 79(8): 699-703, 1978

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Report on the annual meeting

LUMBAR SYMPATHECTOMY IN THE TREATMENT OF BUERGER'S DISEASE

One hundred sixty-eight patients of Buerger's disease were treated at our surgical division. Followup informations were obtained from 71 cases of the patients, with periods varying from 5 to 22 years. Data from clinical records and follow-up informations constitute the basis for the present paper.
1) Lumbar sympathectomy was a valuable method in the treatment of Buerger's desease. The most satisfactory results were obtained in those patients in whom vasospastic conditions were highly associated and in whom vascular disease processes were more distal of the extremity.
2) The standardized technique of lumbar sympathectomy was composed of resection of the second and third lumbar ganglia with their communicating and collateral rami. Regeneration of the sympathetic nerve fibers and supersensitivity of the blood vessels to catecholamine were prevented by the procedure.
3) Bilateral lumbar sympathetic innervation of a single extremity was proved by the retrograde axonal transport method. Contralateral sympathectomy had to be considered to obtain more complete denervation.
4) Plethysmogram showed that lumbar sympathectomy was a valuable adjunct to direct vascular surgery.
5) Eight cases of resympathectomy were presented with satisfactory results.
6) Seventy per cent of the patients showed clinical improvement by lumbar sympathectomy.

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