From January 2018 to December 2020, we performed a retrospective study on 32 cases of chronic lower limb non-atherosclerotic ischemia, included: 24 Buerger patients and 8 Raynauld patients. Patients’ average age was 36.9 years. Male was 4 times more than female. Chief complaints were pallor and leg pain. History of disease was 12.7 months. 93.75% of the lesions happened on one leg. Smoking (81.25%) was prominent risk factor. All cases were successfully performed by endoscopic retroperitoneal lumbar sympathectomy with accurate histopathological result of sympathetic nervous tissue. Operation time: 70.5 ± 11.5 minutes, post-op days: 4.2 ± 2.1 days, hospital days: 10 ± 7.7 days, blood loss volume: 10.3 ± 4.9 ml. There were not operative accidents or complications. In post-op period, 43.75% of the patients had mild pain, others were without pain. 100% of the wounds healed well, no infection was recorded. Short-term results showed a statistic significance of 6 improved symptoms against preoperation. The improved symptoms include: numbness, intermittent claudication, rest pain, pulselessness, coldness, pallor. The mid-term results showed a statistic significance of 6 improved symptoms against preoperation: numbness, intermittent claudication, rest pain, pulselessness, coldness, pallor. But, compared with short-term results, there were 8 progressive symptoms: numbness, intermittent claudication, rest pain, coldness, pallor, gangrene, paralysis. After endoscopic retroperitoneal lumbar sympathectomy, time of amputation was 39.6 months. The common amputation ratio in our study was 25% but the amputation ratio of Buerger group was 33%. Absolute effect on Raynauld group (1 year post-op) showed no case of leg ischemia, no case of amputation.
Keywords: endoscopic retroperitoneal lumbar sympathectomy