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Results for “Sympathectomy”

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At least 19 recordsLinked to original sources

PubMed1978

Influence of surgical sympathectomy on gastric secretion and ulceration in rats.

The influences of sympathectomy on gastrointestinal mucosa, gastric secretion, acute or chronic gastric ulcers were studied in rats. Uncer ether anesthesia, sympathectomy was performed by surgical removal of the celiac ganglion. Surgical sympathectomy per se produced no pathological changes in the gastrointestinal tract as determined by macroscopical observation 3, 10 or 20 days after operation. The volume of gastric juice and pepsin output were not influenced by the sympathectomy but gastric acid output was significantly increased in pylorus-ligated rats. The sympathectomy worsened the stress- and the indomethacin-induced ulcer and delayed the healing of chronic gastric ulcers a little but not significantly, and had no deteriorative influence on the reserpine-induced ulcers. In contrast, Shay ulcers, aspirin- or secrotonin-induced ulcers were significantly aggravated by sympathectomy. The loss of H+ ions and gain of Na+ ions in the gastric juice of pylorus-ligated and aspirin-treated rats were not affected by sympathectomy.

Acetates↗

PubMed1977

Preoperative selection of patients for lumbar sympathectomy by use of the Doppler index.

Yao and Bergan [8] have shown that an ankle systolic index of more than 0.25 is associated with a high rate of success from lumbar sympathectomy. This association has been borne out in our small series. We have also suggested that diseases that obviously compromise collateral circulation might be a relative contraindication to sympathectomy. Although incomplete, literature on collateral flow in relation to sympathectomy tends to confirm this idea. Consideration of such diseases as a contraindication to sympathectomy might further increase the success rate after sympathectomy. Regardless, ankle systolic index alone appears to be a reliable objective, non-invasive method of selecting patients with an increased chance of success from lumbar sympathectomy.

Adult↗

PubMed1977

Clinical results of lumbar sympathectomy alone or as a complement of direct arterial surgery.

Six hundred and eighty patients underwent conservative surgery for chronic obliterative arterial disease of the lower limbs during a 15 year period ranging from 1960 to 1974. Two hundred and fifty-three lumbar sympathectomy were performed in 240 patients, 339 patients had direct surgery and in 133 cases lumbar sympathectomy was added to direct surgery. From this experience the authors conclude: 1. Lumbar sympathectomy has a low mortality rate (3 deaths or 1.18%) and no important after effects: in particular no sexual problems are reported. 2. Lumbar sympathectomy for intermittent claudication seems to be useful since it apparently improves symptoms and prognosis of the operated leg. 3. Lumbar sympathectomy for rest pains or necrosis can be useful in 1/3 of the patients with proximal arterial lesions and in 2/3 of the patients with only peripheral lesions. 4. Lumbar sympathectomy should always be added to direct arterial surgery above the inguinal ligament since it improves the patency rate of arterial reconstruction without increasing the operative risk.

Arterial Occlusive Diseases↗

PubMed1977

Value of concomitant sympathectomy in aortoiliac reconstruction. Results of a prospective, randomized study.

The efficacy of concomitant lumbar sympathectomy in improving results of aortoiliac reconstruction was assessed by a prospective, randomized study of 51 patients undergoing operation for occlusive or aneurysmal disease. Sympathectomy was performed on 50 limbs, while 52 extremities served as controls. Sympathectomy resulted in a significant reduction in foot vascular resistance determined by plethysmography. However, the procedure had no effect on leg circulation, assessed by ankle/arm pressure indices determined by Doppler ultrasound. In the sympathectomy group, there were three early postoperative amputations for ischemia, despite patent grafts. In the control group, there was one late graft occlusion, caused by progressive atherosclerotic disease. Although sympathectomy may improve pedal circulation, the procedure does not appear to improve the results of aortoiliac reconstruction.

Adult↗

PubMed1976

Chemical lumbar sympathectomy.

The technique of injection and the results of a series of 124 chemical lumbar sympathectomies, performed on 97 patients, are described. Sixty-eight patients, over 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Fifty-two of these patients benefited in terms of pain relief and only one required amputation. Sixteen patients, under 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Ten of these patients benefited but it is recommended that, where possible, other methods of treatment should be used in this younger age group. Thirteen patients, mostly elderly, had their sympathectomy because of diabetic ischaemic disease. Six only of these patients benefited, but it is felt that chemical sympathectomy can be recommended as a way of helping some of these patients who would otherwise have amputation.

Age Factors↗

PubMedDate not supplied

Effect of lumbar sympathectomy on the lower extremity.

1. Lumbar sympathectomy creates a state of vasodilatation equivalent to physiological vasodilatation of daily living; however, after sympathectomy, vasodilatation is permanent and irreversible. 2. This vasodilatation is characterized at rest by a preferred distribution of blood to the skin and to subcutaneous cellular tissue of the lower extremity, foot and toes. 3. This vasodilatation, although permanent, does not interfere with increased output to muscles at work. They benefit by a particular mechanism of metabolic vasodilatation (Fig. 6). 4. Lumbar sympathectomy has a beneficial effect on the collateral compensatory circulation of an obliterated large artery. This effect is induced by suppression of the peripheral resistance, and thus, by increasing the pressure gradient. 5. The vasodilatation obtained by intravenous injection of pentothal is qualitatively the same as that which follows a lumbar sympathectomy. The test with pentothal, because of this action, is an excellent method for prognosis and control of lumbar sympathectomy effects.

Angiography↗

PubMed1976

Chemical sympathectomy and two-way escape and avoidance learning in the rat.

Six experiments are reported on the effects of 2,4,5-trihydroxyphenylethyl-amine (6-hydroxydopamine) on two-way escape and avoidance learning. Rats were tested on either escape or avoidance learning at 80 days of age after chemical sympathectomy at birth or 40 or 80 days of age. Neonatal and chronic sympathectomy (at 40 days), but not acute sympathectomy (at 80 days), resulted in depressed escape learning. Avoidance learning was affected by neonatal sympathectomy and partially by acute sympathectomy. The results have implications for the role of the autonomic nervous system in escape-avoidance learning.

Age Factors↗

PubMed1979

Unique resistance to guanethidine-induced chemical sympathectomy of spontaneously hypertensive rats: a resistance overcome by treatment with antibody to nerve growth factor.

The chronic administration of high doses of guanethidine to rats produces complete destruction of the peripheral sympathetic nervous system. In a study of the effect of guanethidine-induced sympathectomy on the development of hypertension is spontaneous hypertensive rats (SHR, Okomoto strain), only a partial sympathectomy could be produced as assessed by biochemical parameters (tyrosine hydroxylase activity in ganglia and tissue norepinephrine concentrations) and by evaluation of response to stimulation of vasomotor outflow in pithed rat preparations. Other strains of rats (Sprague-Dawley, American Wistar, Kyoto Wistar) were uniformly sensitive to guanethidine sympathectomy. The resistance to guanethidine was not due to a lower accumulation of guanethidine in the neurons of SHR. Addition to the guanethidine treatment of low doses of antibody to nerve growth factor (NGF), which itself produced only a modest sympathectomy, resulted in an almost complete sympathectomy. SHR did not become hypertensive when sympathectomized by combined guanethidine-anti NGF. These results show that the sympathetic neurons of SHR differ from those of other strains with respect to sensitivity to guanethidine cytotoxicity and suggest the possibility of a role for NGF in that altered responsiveness.

Animals↗

PubMed1978

Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis.

An endoscopic technique is described for thoracic sympathectomy. After establishment of a pneumothorax, the thoracoscope is introduced into the pleural cavity. The telescope is equipped with a wire electrode, a grasping forceps, and a suction coagulation probe for endoscopic electroresection of the sympathetic trunk. In 63 patients, 124 endoscopic sympathectomies were performed. All patients were relieved of sweating in the hands; 18.6% still had some perspiration of the axilla. Side effects of thoracic sympathectomy were compensatory and gustatory sweating that, in four patients, were more embarrassing than the original form of hyperhidrosis. Fifty-five patients were highly satisfied with the result of endoscopic sympathectomy, which is considered the appropriate minor procedure for the treatment of upper limb hyperhidrosis, causing minimal discomfort to the patient and almost invisible scars.

Adolescent↗

PubMed1978

The immediate effect of lumbar sympathectomy on arterial blood flow measured by electromagnetic flowmetry.

The immediate effect of lumbar sympathectomy on arterial blood flow was studied in 51 patients with peripheral arterial disease by means of electromagnetic flowmetry. Concomitant arterial reconstruction was performed in 37 cases. The measurement was made on the reconstructed segment or on the bypass graft, and on the femoral artery when sympathectomy alone was performed. The flow increase varied considerably from case to case and was rather unpredictable. There was no significant correlation between the effect of sympathectomy and peripheral arterial disease or the condition of the outflow tract. Thus, on the basis of these measurements, it is difficult to determine the significance of lumbar sympathectomy as a method of increasing blood flow.

Adult↗

PubMed1977

[History of lumbar sympathectomy from its origin to the present].

The author first recalls the origins of the words "sympathetic" and "neurovegetative system" and then outlines the beginnings of surgery on the autonomic nervous system in general. This started with the section of the rami communicantes introduced by the Australians Royle and Hunter in surgery of the muscle tone. Then nearly at the same time in 1924. Adson in USA and J. Diez in Argentina resected the lumbar sympathetic chains; the latter mainly for treatment of thromboangeitis obliterans. From 1924 on, lumbar sympathectomy met with rapid success as shown at the Cairo Congress of 1935. Physiologic and pathologic effects of lumbar sympathectomy are analysed and the usual techniques are reviewed. The author then lists the specific postoperative complications, including the pain symdroms and the functional sexual disorders in males. Finally the principal indications where lumbar sympathectomy proved useful are named. Chronic obliterative arteriopathies are the first. For these lumbar sympathectomy still holds a palliative, supportive or absolute role. A scheme illustrates its beneficial actions.

Arterial Occlusive Diseases↗

PubMedDate not supplied

Evaluation of effectiveness of lumbar sympathectomy by non invasive diagnostic techniques.

Out of a total of more than 1,200 patients in whom lumbar sympathectomy was carried out, two groups of 96 and 50 consecutive and non selected patients were evaluated before and after the operation by non invasive physiologic tests (digital plethysmography, post-occlusive reactive hyperemia, segmental blood pressure at rest and after exercise, Strandness test). Results were compared with angiography and clinical data. The statistical study of results corroborates the following points. 1. Lumbar sympathectomy is essentially effective in atherosclerotic arterial disease, but much less so in diabetic patients and in cases of widespread disease. 2. Patients with obstructive disease of the femoral artery had more improvement (t = 4.25) than patients with obstruction of peripheral arteries (t = 2.4). 3. Walking time was significantly improved after sympathectomy (p = 0.02). 4. Only one parameter, rheographic quotient Rq was statistically improved (p = 0.01). 5. The post occlusive reactive hyperemia test is a good method to predict the results of lumbar sympathectomy (correlation r = 0.22). We feel that this operation is indicated in cases of: isolated obstruction of the femoral artery with claudication superior to 200 meters, reconstruction with an associated obstruction of the superficial femoral artery.

Aged↗

PubMed1977

Lumbar sympathectomy.

The three points discussed in this paper are: 1. Improvement in walking distance. 2. Post-sympathectomy neuralgia. 3. Post-sympathectomy ejaculatory problems. The experience in the paper was derived from 2,450 operations of lumbar sympathectomy carried out between the years of 1947 and 1972. The claudicant patients were divided into 3 main groups. Those who were not treated by any form of surgery, those who could walk for 200 yards before claudication and those who could walk less than 100 yards before claudication, the latter two groups having been treated by lumbar sympathectomy. The results show a considerable difference in the two groups treated and compare favourably with the untreated cases.

Arterial Occlusive Diseases↗

PubMed1977

[Present place of lumbar sympathectomy in arteritis of the lower limbs (author's transl)].

A study of 75 lumbar sympathectomy helped the authors in specifying the indications of this operation for arteritis of the lower limbs. Lumbar sympathectomy is based on precise anatomical facts : para-vertebral sympathetic chain is usual but a collateral chain must be searched if the latter appears too thin. Lumbar sympathectomy can be performed alone or in association with reconstructive procedures. It is used alone in old people for its antalgic and moderately functional effect in accordance with their level of activity. Also it is used alone in cases of gangrene localized or pending or in the absence of a runoff vasculature. It is associated to repair if one wants to improve an incompetent peripheral perfusion. The authors record 79% of favourable results of which 52% were maintained when lumbar sympathectomy was used alone. In patients where direct vascular surgery is added, favorable results account for 82% of which 78% long lasting.

Aged↗

PubMed1977

Direct measurement of arteriovenous anastomotic blood flow after lumbar sympathectomy.

Absolute blood flows through hind limb capillaries and arteriovenous anastomoses (AVA) were determined by the radioactive microsphere technique of relative shunt measurement combined with direct (electromagnetic) measurement of femoral artery flow. Hemodynamic parameters were measured before and after laparotomy, after unilateral lumbar sympathectomy, during reactive hyperemia, and during alpha adrenergic blockade in normal and sympathectomized hindlimbs of six anesthetized dogs. After sympathectomy arteriovenous (A-V) shunting increased from 3.8 to 32.1% (p less than 0.05). AVA flow increased from 4 to 54 ml/minute (p less than 0.01), while capillary flow was unchanged. Nonsympathectomized limbs did not demonstrate these changes. During reactive hyperemia, capillary flow increased more than 100% (p less than 0.03) in both normal and sympathectomized limbs, while AVA flow was unchanged. After phentolamine (5 mg, intravenously), AVA flow increased from 2 to 19 ml/minute (p less than 0.01) only in nonsympathectomized limbs. Phentolamine mimicked surgical sympathectomy effects in nonsympathectomized limbs, with paw temperature, femoral flow, A-V O2 difference, A-V shunting, AVA flow, and capillary flow equal to sympathectomized limbs after phentolamine administration. In the acute canine model, increased blood flow after sympathectomy is due to increased nonnutritive AVA flow, with no change in total hindlimb capillary flow, both at rest and during reactive hyperemia.

Animals↗

PubMed1978

Analysis of intestinal cell proliferation after guanethidine-induced sympathectomy. I. Stathmokinetic, labelling index, mitotic index, and cellular migration studies.

Guanethidine-induced sympathectomy in the rat during the neonatal period (injection of 20 microgram/g body weight every 48 h from day of birth until day 14) produces an absolute reduction in the number of sympathetic ganglion cells, but no significant alteration of body weight. Superior cervical ganglia show 79.8% fewer cell bodies at 15 days and 92.3% at 45 days; coeliac ganglia exhibit an 81.0% reduction at 15 days and 89.6% at 45 days in guanethidine-treated rats as compared to normal controls. The sympathetic ganglion cells that remain after treatment have an abnormal morphological appearance with distended mitochondria and depletion of endoplasmic reticulum. Sympathectomy produces a prolongation of the generation cycle time (Tc) as measured by the colchicine-induced mitotic arrest technique, and a decrease in labelling, mitotic, and migration indices. In addition, sympathectomy suppresses the amplitude of the circadian rhythm in mitotic activity. The general suppression of this activity in the intestinal epithelium is more pronounced in the jejunum and ileum than in the duodenum. Variation in the effectiveness of sympathectomy on the inhibition of intestinal cell proliferation may be related to segmental differences in cell proliferation, to segmental differences in innervation, and/or to segmental variation in the effectiveness of guanethidine.

Animals↗

PubMed1976

Modification and characterization of the permanent sympathectomy produced by the administration of guanethidine to newborn rats.

The administration of guanethidine to newborn rats has been shown to produce a permanent sympathectomy with potential advantages over immunosympathectomy and 6-hydroxydopamine-induced chemical sympathectomy. In this paper, we report on a revised treatment regimen involving initiation of treatment (50 mg/kg/day) on day 7 after birth and continuing for 3 weeks. Animals treated by this protocol have a low mortality rate (approx. 10% above saline-treated controls) and no permanent growth deficit. Analysis of tyrosine hydroxylase activity in and light microscopic examination of superior cervical ganglia of the guanethidine-treated animals indicate complete destruction of sympathetic neurons by the end of the second week of treatment. During and after treatment there are no decreases in norepinephrine in whole brain of the treated animals. Norepinephrine levels in peripheral tissues are markedly reduced at both 9 and 16 weeks of age. Stimulation of vasomotor outflow produces no increase in blood pressure in guanethidine-treated rats at 9 or 26 weeks of age, indicating a complete and permanent functional denervation of the vasculature. The adrenal glands of the guanethidine-treated animals are not destroyed, but rather respond, apparently by transsynaptic induction, with increases in tyrosine hydroxylase and epinephrine content. Interestingly, despite the continued deprivation of a peripheral sympathetic nervous system in these animals. adrenal tyrosine hydroxylase and epinephrine levels return to control levels by 10 weeks of age. These data indicate that administration of guanethidine to newborn rats produces a very complete and permanent sympathectomy with significant advantages over immunosympathectomy and 6-hydroxydopamine-induced chemical sympathectomy.

Adrenal Glands↗

PubMed1979

Effect of neonatal sympathectomy by 6-hydroxydopamine on volume and resistance regulation in stroke-prone spontaneously hypertensive rats.

1. Neonatal sympathectomy with 6 hydroxy-dopamine (6-OHDA) was used as a tool to assess the significance of an increased sympathetic vascular tone for the development of high blood pressure in stroke-prone spontaneously hypertensive rats. After administration of 6-OHDA the rise in blood pressure was blunted for the following 9 weeks until innervation was re-established. 6-OHDA-treated rats retained more sodium and had larger plasma and blood volumes than sham-treated rats. 2. Catecholamines in plasma were increased 2-10-fold immediately after sympathectomy, but their concentrations were subnormal on day 7. Eight weeks after sympathectomy plasma noradrenaline and dopamine were not elevated, but plasma adrenaline has increased twofold. 3. The reactivity of resistance vessels to noradrenaline was markedly enhanced and the neuronal uptake and metabolism of noradrenaline were still reduced 8 weeks after neonatal sympathectomy. 4. These results confirm the significance of an intact sympathetic nervous system for the development in these rats. Sodium retention and increased plasma and blood volume may be considered as a compensatory mechanism for the vasodilatation resulting from decreased vasomotor tone.

Animals↗