J.Jpn. Surg. Soc.. 79(8): 704-706, 1978

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Report on the annual meeting

SPECIAL COMMENT

Comments were given on papers presented at the panel. Reconstructive surgery is indicated in relatively few cases with Buerger's diseases. Vein bypass graft is preferable as Dr. Maruyama reported. Long patency rate is estimated to be less than 50 per cent, though his results are good. Dr. Kusaba's method is technically very difficult and so is not recommended though he shows good results.
Omental transplantation is a rather extensive procedure and so is not considered to be indicated for salvage of toes. It should be preseved as a final method for limb salvage.
Indication, effects and limit of lumbar sympathectomy are well understood. Its effects are excellent and long standing in cases where it was done technically correctly with good indication. There are many cases where technically poor operation was performed.
Intraarterial infusion therapy with prostagrandine etc.is not recommended because of possible damage to arterial wall by mechanical injury.
It should be emphasized that apparently intracutable wound will be cured by proper local treatment and minor amputation in many cases. Definite hypercoagulability is found in patients with Buerger's disease, especially in recurrent cases. Long term anticogulant therapy should be considered in these cases with abstinence of smoking.

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