Objective: To determine the effectiveness of digital sympathectomy for treatment of chronic digital ischemia, to provide information on outcomes of this surgical procedure, and to give recommendations for further investigations.
Methods: We conducted a systematic review of English language citations referring to digital sympathectomy published between 1966 and 2002 using Premedline and Medline.
Results: Multiple differences in surgical techniques, causes of digital ischemia, and outcome measurements among studies made comparisons of surgical outcomes difficult. We found that 14% of all patients required amputation and 18% of patients had ulcer recurrence. Some type of postoperative complication was reported in 37% of patients with systemic sclerosis.
Conclusion: To best determine the effectiveness of this surgical procedure, we recommend that future studies are prospective, to include standardized pre- and postoperative measurements, stratify the study outcomes by diagnosis and disease duration, and have consistent postoperative followup intervals.