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Minimally Invasive Techniques |

Use of Endoscopic Transthoracic Sympathicotomy in Intractable Postherpetic Neuralgia of the Chest*

Isao Matsumoto, MD; Makoto Oda, MD; Hiromoto Shintani, MD
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*From the Departments of Surgery (Dr. Matsumoto) and Internal Medicine (Dr. Shintani), Komatsu Municipal Hospital, Komatsu, Japan; and the First Department of Surgery (Dr. Oda), Kanazawa University School of Medicine, Kanazawa, Japan.

Correspondence to: Isao Matsumoto, MD, the Department of Surgery, Komatsu Municipal Hospital, Ho 60 Mukaimotoori-machi, Komatsu 923-8560, Japan; e-mail adress: naochan@f3.dion.ne.jp



Chest. 2002;122(2):715-717. doi:10.1378/chest.122.2.715
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Although there are various treatments for postherpetic neuralgia (PHN), none produces definitive effects. We report a case of 72-year-old woman who developed intractable PHN of the chest in which treatment with endoscopic transthoracic sympathicotomy (ETS) produced long-term effective results. When hyperesthesia of the sympathetic nerve participates in PHN, the blocking of sympathetic excitation seems to be effective for PHN suppression. The method using a single resectoscope is safe, accurate, yields excellent results cosmetically, and generates minimal invasion and very little postoperative pain. Although ETS is not always effective for all cases of PHN, it could be a useful method of treating patients with PHN that is resistant to conventional therapies.

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