| Objective To summarize the clinical efficacy of selective neurotomy combined with tibial transverse transport (TTT) technique in the treatment of thromboangiitis obliterans (TAO) of the lower extremities in our hospital.Methods A retrospective analysis of the medical records of 60 TAO patients who underwent selective neurotomy combined with the TTT technique at the People's Hospital of the Xinjiang Uyghur Autonomous Region between October 2017 and October 2023 was conducted. Firstly, extensive debridement was performed on the foot ulcer wounds of all patients to thoroughly remove necrotic and pathological tissues. Based on preoperative physical examinations and intraoperative exploration results, the sensory nerves corresponding to pain-sensitive areas were accurately located and underwent thorough neurolysis. For nerves with significant demyelinating lesions, partial selective neurotomy was performed intraoperatively. Subsequently, TTT surgery was conducted. Follow-up visits were arranged to compare patients' dorsal foot skin temperature, transcutaneous oxygen pressure (TcPO2), ankle-brachial index (ABI), intermittent claudication distance, visual analog scale (VAS) for pain, and wound healing status before and after surgery, comprehensively assessing the therapeutic effects.Results All patients in this group were followed up for 6-12 months, with an average of (8.0±2.4) months. Of the 60 patients, 57 patients (95%) experienced primary healing of chronic ulcer wounds postoperatively, 3 patients (5%) had delayed healing and 2 patients (3.3%) had pin tract infections. Rest pain or intermittent claudication in the extremities was completely relieved during the perioperative period, with no complications such as ulcer recurrence or fractures occurring. Postoperative dorsal foot skin temperature, TcPO2, ABI, intermittent claudication distance, and VAS scores were significantly improved compared to preoperative levels, with statistically significant differences (P<0.05).Conclusion Selective neurotomy combined with TTT in the treatment of TAO is minimally invasive and demonstrates significant clinical efficacy, especially for ischemic pain in the extremities caused by vascular occlusion. Provided that appropriate surgical indications are selected, this method is worthy of clinical promotion and application. |
