Evidence map›Paper›PMID 39511575›Full record

Trial reportBMC surgery2024

Laparoscopic versus open lumbar sympathectomy in critical limb threatening ischemia patients in Egypt.

Wael E Shaalan, Ali A Elemam, Hassan Lotfy, Ahmad R Naga, Mohamed I Mohamed, Yomna E Dean, Tamer N Abdelbaki

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Thoracoscopic Sympathectomy in Treatment-Resistant Essential Hypertension: A Novel Approach to Reduce Sympathetic Activity and Blood Pressure.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Wael E ShaalanVascular Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt.
Ali A ElemamVascular Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt.
Hassan LotfyVascular Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt.
Ahmad R NagaVascular Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt.
Mohamed I MohamedAlexandria University, Faculty of Medicine, Alexandria, Egypt.
Yomna E DeanAlexandria University, Faculty of Medicine, Alexandria, Egypt. yomna.mohamed1772@alexmed.edu.eg.
Tamer N AbdelbakiGeneral Surgery Department, Alexandria University, Faculty of Medicine, Alexandria, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe treatment of critical limb-threatening ischemia (CLTI) is revascularization. Lumbar sympathectomy (LS) could be attempted when this is not amenable. Using laparoscopic techniques to perform LS adds the advantages of minimally invasive surgery.

methodsTwenty-four patients, presenting with non-reconstructable CLTI and rest pain, were randomly divided into group I (14 patients) who underwent retroperitoneoscopic lumbar sympathectomy (RPLS) and group II (10 patients) who had conventional open lumber sympathectomy (COLS).

resultsRPLS patients had shorter hospital stays, fewer intraoperative complications, and less postoperative pain. However, the mean operative time was significantly longer (86.4 ± 9.1 min, p-value: 0.02) in the RPLS group but decreased with each subsequent case after that. The differences in post-operative capillary refill time, ABI, TBI, and TcPO2 were not statistically significant between both groups (p-values: 0.97, 0.13, 0.32, 0.10, respectively). However, the difference in the quality-of-life score was statistically significant; the mean (± SD) SF-36 score increased from 48 ± 6.8 to 81 ± 4.4 (p-value < 0.001) in RPLS group compared to 52 ± 8.8 to 59 ± 1.2 (p-value: 0.52) in COLS group.

conclusionRPLS is feasible, safe, and has the advantages of minimally invasive surgery: minimal blood loss, less intraoperative complications, shorter hospital stay, and less postoperative pain. However, the operative time in RPLS cases is longer than in the COLS; training on the procedure is recommended to improve the learning curve.

Indexed as

IschemiaLaparoscopySympathectomyAdultEgyptFemaleHumansLength of StayLumbosacral PlexusMaleMiddle AgedOperative TimeTreatment OutcomeChronic limb-threatening ischemiaCritical limb ischemiaLaparoscopic assisted surgeryLaparoscopic surgeryLaparoscopic sympathectomyLaparoscopyLumbar sympathectomyPeripheral arterial diseasePeripheral artery diseasePeritoneoscopySympathectomySympathetic denervation

Identifiers

PMID39511575
PMCPMC11542267

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.