The Clinical Study Of Combined Interventional Therapy, Laparoscopic Lumbar Sympathectomy And Peripheral Hematopoietic Stem Cells Transplantation For The Treatment Of Thromboangiitis Obliterans

Objective: To investigate the feasibility and both the early and long-term effects of the joint of intervention treatment and laparoscopic resection of lumbar sympathetic trunk and autogenetic blood stem cell transplantation for the treatment of thromboangiitis obliterans.Methods: 21 patients, from January 2006 to January 2009, were treated with the joint of intervention techniques and laparoscopic resection of lumbar sympathetic trunk and autogenetic blood stem cell transplantation according to the involved scopes of the disease. Both the intra-operative and post-operative complications, the ratio of technique success and the clinical effects were investigated. Then the initial patency rate, the long-term patency rate, the limbs salvage rate and the survival rate were determined through follow-up.Results: Two cases of 21 developed early technical complications(9.5%), with one hematoma after puncturation and the other developed inguinal and oscheal subcutaemphysema after retroperitoneal laparoscopy. No complications occured after autogenetic blood stem cell transplantation. The resection of lumbar sympathetic ganglia with retroperitoneal laparoscopy were done 3 to 5 days after the intervention. 7 days after the resection of lumbar sympathetic trunk, the bone marrow stem cells were stimulated to proliferate and released into circulation with recombinant human granulocyte colony-stimulating factor. On the 5th to 6th day since the stimulation, the peripheral blood stem cells were collected through the CS-3000 PI US blood cell separator and then concentrated and injected into the ischemic muscles, which were the courses of autogenetic stem cell tranplantation. The follow-up from 1 to 24 months after the operation showed relieved rest pains, healing ulcers and extended claudication both in time and distences.Conclusion: The joint of intervetion treatment and retroperitoneal laparoscopy and autogenetic stem cell transplantation were successful for the thromboangiitis obliterans in both initial technical and clinical aspects, which is an safe and effective treatment.