Efficacy of Lumbar Chemical Sympathectomy in the Healing of Indolent Venous Ulcers: A Prospective Study | ||||
| Minia Journal of Medical Research | ||||
| Articles in Press, Accepted Manuscript, Available Online from 10 August 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2025.408216.2057 | ||||
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| Authors | ||||
Mostafa Mohamed Abdel Gany1; George Abdel-Shaheed Yakoub2; Ahmed Hassanein3; Abanoub Nasser Georgios  4; Michael Samuel Ayad5; Mostafa Elsanadeki Elsanadeki6; Momen Mostafa El-Sanadeki7
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| 1Vascular Surgery Department, Minia Faculty of Medicine, Minia University Hospitals | ||||
| 2Anesthesia and intensive care department ,Minia University, Minia university hospital,Minia, Egypt | ||||
| 3Department of Anesthesia, El-Minia Faculty of Medicine | ||||
| 4Department of vascular surgery, Faculty of medicine, Minia University, © department of Anesthesia and ICU and pain management, Faculty of medicine, Minia University | ||||
| 5Vascular Surgery department Faculty of Medicine - Minia University | ||||
| 6*Department of vascular surgery, Faculty of medicine, Minia University, © department of Anesthesia and ICU and pain management, Faculty of medicine, Minia University | ||||
| 7Department of General & Vascular Surgery, Minia Faculty of medicine, El-Minia University | ||||
| Abstract | ||||
| Background: Venous leg ulcers (VLUs) are chronic wounds associated with venous hypertension, leading to significant morbidity and healthcare burden. Standard management includes compression therapy and venous intervention, yet a subset of patients remains refractory to these treatments. Aim: This study aimed to evaluate the efficacy and safety of fluoroscopy-guided lumbar chemical sympathectomy using 6% phenol in promoting healing and pain relief in patients with chronic, indolent venous leg ulcers. Methods: A prospective study was conducted on 40 patients with recurrent, non-infected VLUs unresponsive to standard therapy. All patients underwent lumbar chemical sympathectomy targeting the L2–L4 ganglia using 6% phenol under fluoroscopic guidance. Pain scores (VAS), ulcer healing rates, complication profiles, recurrence rates, and patient satisfaction were assessed over a 3-month follow-up Results: A significant reduction in pain was observed one week post-procedure (VAS score: 7.5 ± 0.87 reduced to 2.45 ± 0.87, p < 0.001). The mean healing rate reached 84.1% at 3 weeks, with 90% of patients achieving complete ulcer healing and 95% reporting complete pain relief by 3 months. The recurrence rate was 7.5%, and complications were minimal, including transient neuralgia (5%) and genitofemoral nerve irritation (5%). Patient satisfaction was high (85%) Conclusion: Lumbar chemical sympathectomy is a safe and effective adjuvant treatment for chronic VLUs, offering significant pain relief and promoting rapid healing in patients unresponsive to conventional therapy. Further controlled studies are recommended to validate these findings. | ||||
| Keywords | ||||
| Venous leg ulcer; lumbar sympathectomy; phenol injection | ||||
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