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KMID : 0371320010600010073
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Journal of the Korean Surgical Society
2001 Volume.60 No. 1 p.73 ~ p.77
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Thoracoscopic Splanchnicectomy for the Relief of Intractable Upper Abdominal Cancer Pain
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Chae Yoon-Seok
Kim Kyung-Sik
Lee Woo-Jung
Kim Byong-Ro
Paik Hyo-Chae
Lee Jong-Hoon
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Abstract
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Purpose: Pain is the most distressing feature of cancer patients. Thoracoscopic splanchnicectomy, first performed in 1993, has caused a resurgence of interest in surgical treatment of such excruciating pain. We wish to introduce a method of splanchnicectomy.
Methods: Five patients underwent a splanchnicectomy for intractable cancer pain, over a period of 11 months. We evaluated the type of splanchnicectomy performed and the results. The procedure was done using a double lumen catheter to deflate the lung at the operation side under general anesthesia with the patient in the lateral decubitus position. A small opening was made with scissors in the pleura of the 5th intercostal space to expose the terminal branch of the greater splanchnic nerve. Six∼Seven branches of splanchnic nerve were cut downward until the splanchnic nerve trunk and then cut. A left thoracoscopic splanchnicectomy was done in one case, and a bilateral thoracoscopic splanchnicectomy in four cases.
Results: The splanchicectomy appears to result in significant reduction of abdominal pain in all cases. There were no postoperative complications.
Conclusion: As a conclusion, thoracoscopic splanchnicectomy is the treatment of choice for intractable intraabdominal cancer pain, affording drug cessation and recovery of daily activity in most patients.
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KEYWORD
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Thoracoscopy, Splanchnicectomy
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