К ВОПРОСУ О ДЕСИМПАТИЗАЦИИ ВЕРХНЕЙ КОНЕЧНОСТИ ПРИ ФЕНОМЕНЕ РЕЙНО

Abstract

Objective: The review discussed the most important aspects of the implementation of various variants of upper sympathectomy under the Raynaud’s phenomenon. A short characteristic given, the indications, effectiveness and frequency of complications of open, video-thoracoscopic and periarterial digital sympathectomy, as well as the methods of chemical sympatholysis disclosed. The reasons for the relapse of the Raynaud’s phenomenon, in particular, include the preservation of additional sympathetic innervation of the upper limb, progressive immune aggression, rapid regeneration of the intersected nerve trunks, and the variability of the anatomy of the sympathetic nervous system discussed in details. In addition, the work reflects the issues of the volume of cervical and thoracic sympathectomy and their comparative effectiveness in the early and late periods of observation. The literature data show that the effectiveness of sympathectomy in the long-term follow-up period remains at 43.3-93.3% and depends, first, on the method of its conduct, the stage and genesis of the disease, and on the effect of trigger factors of vasospasm. Despite the contradictory results of the upper extremity sympathectomy in the Raynaud’s phenomenon, it continues to be the only hope in the arsenal of vascular surgeons, which in most cases can improve the circulation of the fingers and the hand. Keywords: Raynaud’s phenomenon, thoracic sympathectomy, chemical sympatholysis, videotoracoscopy, results.