Surgical laparoscopy, endoscopy & percutaneous techniques
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The objective was to evaluate the safety and effectiveness of endoscopic thoracic sympathectomy (ETS) for treatment of a variety of sympathetic disorders, including hyperhidrosis, splanchnic pain, reflex sympathetic dystrophy, and Raynaud upper extremity ischemia. Sixty-three ETS procedures were performed in 34 patients at the University of Maryland Medical System between March 1992 and August 1999 (14 male patients, 20 female patients; mean age 22 years). The indications for surgery were hyperhidrosis in 26 patients, upper extremity ischemia in 3 patients, splanchnic pain and reflex sympathetic dystrophy in 2 patients each, and facial blushing in 1 patient. ⋯ These findings suggest that ETS is a safe and effective procedure for treatment of a variety of sympathetic disorders. Its application for hyperhidrosis is very effective, and its treatment of splanchnic pain, reflex sympathetic dystrophy, and Raynaud syndrome are rewarding. With increasing experience, ETS should become established in the repertoire of the thoracic surgeon.
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Surg Laparosc Endosc Percutan Tech · Oct 2000
Laparoscopic drainage of postoperative complicated intra-abdominal abscesses.
Intra-abdominal abscess, which carries significant rates of death and complications, may complicate the postoperative course. Treatment options include percutaneous needle aspiration, placement of an external drain under ultrasonic guidance, or surgical drainage, depending on the size, site, and nature (simple or complicated) of the abscess. Laparoscopic drainage may be a treatment option. ⋯ The suction drain was removed on average 5 days after laparoscopy, and the mean hospital stay was 6 days. There was no recurrence of symptoms at a mean follow-up of 23 months. Laparoscopic drainage, in combination with systemic antibiotics, is a safe and effective treatment option in patients with postoperative complicated intra-abdominal abscesses.