外科ジャーナル

Thoracoscopic Left Splanchnicectomy: Two Trocar Technique

Abstract

George Jinescu, Ion Lica, Septimiu Andrei, Cornelia Chidiosan and Mihnea Dinu

Background: Abdominal hyperalgic syndrome in unresectable pancreatic cancer worsens the quality of patients' life. The goal of this article is to evaluate the feasibility of performing the left splanchnicectomy using a two trocar thoracoscopic approach.

Material and Methods: One patient suffering from intractable pain due to unresectable pancreatic cancer (stage IV) with liver metastasis underwent thoracoscopic unilateral left splanchnicectomy. The procedure was performed using only two trocars, one of 10 mm for the optic and one 5 mm working trocar for Hook electrocautery, scissors and grasper. To assess pain severity and the impact of this palliative procedure for pain relief, the patient completed Wong-Baker Faces Pain Rating Scale with a preoperative pain degree of 9.

Results: Surgical procedure time was 30 minutes. Pleural drainage tube was removed 24 hours postoperatively. There were no complications. Immediate pain relief (pain degree 0 to 2) was achieved after thoracoscopic unilateral splanchnicectomy, same level beeing registered at first checkup after one month.

Conclusions: Thoracoscopic unilateral left splanchnicectomy using two trocars is feasible in selected cases, decreasing substantial the pain and significantly improving the quality of life in patients with unresectable pancreatic cancer.