BUERGERS-DISEASE IN HONG-KONG - A REVIEW OF 89 CASES

Background: A retrospective analysis of 103 case records from 1978 to 1996 with a provisional diagnosis of Buerger's disease was undertaken at the Department of Surgery, University of Hong Kong, Queen Mary Hosp ital. The aim of the study was to elucidate the clinical course and ev aluate the results of surgical intervention of Buerger's disease in Ho ng Kong Chinese people. Methods: Fourteen patients were subsequently e xcluded from the study because of inability to fulfil our diagnostic c riteria. Data on clinical presentation, investigations, indications an d results of surgical intervention were reviewed. Sympathectomies and arterial reconstructions were performed on 42 and four patients, respe ctively, for critical ischaemia or rest pain. Outcome was analysed wit h respect to the rate of ulcer healing, pattern of recurrence and limb loss. Results: The patients were all young male heavy smokers with a mean age of 36.5 years. The majority of patients (80%) presented with ischaemic ulceration or gangrene. Vascular reconstruction was undertak en in four patients and satisfactory long-term results were obtained i n three patients. Sympathectomy was able to relieve symptoms in 87% of operated patients and ischaemic ulceration healed in 2.6 (mean) +/- 1 .7 (SD) months after the operation, If the patient continued to smoke, surgical intervention did not exempt the patient from a relapse or am putation. Conclusion: Sympathectomy provides short-term pain relief an d promotes ulcer healing in patients with Buerger's disease but carrie s no long-term benefit. Complete abstinence from smoking is the only m eans of arresting the progression of the disease.