{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:19:14Z","timestamp":1768436354337,"version":"3.49.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T00:00:00Z","timestamp":1598400000000},"content-version":"vor","delay-in-days":238,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Secondary Raynaud\u2019s is a manifestation that can present in CREST syndrome as a variant of five different diseases: Calcinosis, Raynaud\u2019s phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia. Secondary Raynaud\u2019s presents as a result of an imbalance between vasoconstriction and vasodilation potentially leading to tissue ischemia. The mainstay treatment is medical while surgery treatment preserved as a last resort.<\/jats:p>\n <\/jats:sec>\n \n Presentation of case<\/jats:title>\n A 28-year-old female presented with secondary Raynaud\u2019s and was subsequently diagnosed with CREST syndrome. The patient failed to respond to medical treatment, and gangrene of the right fourth distal phalanx developed. Stellate ganglion block was successfully used as a bridge to surgery. Uniportal video-assisted thoracoscopic surgery (VATS) sympathectomy was performed via a 2-cm incision, the sympathetic ganglia were identified and transected by cauterization at the level of the 3rd, 4th, and 5th intercostal spaces extending for a distance of 5 cm to ensure that the nerve of Kuntz was transected. The postoperative outcome was satisfactory, and the condition of the patient improved in a few months.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Different management modalities have been used to relieve the symptoms of secondary Raynaud\u2019s. The treatment ranges from lifestyle modification, medical treatment, and lastly surgical intervention. Sympathectomy has been suggested for the management of refractive secondary Raynaud\u2019s owing to its considerable clinical response.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The use of uniportal VATS sympathectomy results in favorable cosmetic and clinical outcomes including reduced length of hospital stay and postoperative pain.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.08.041","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T11:36:46Z","timestamp":1598873806000},"page":"203-206","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Bilateral uniportal video-assisted thoracoscopic sympathectomy for managing secondary Raynaud\u2019s in CREST syndrome"],"prefix":"10.1097","volume":"75","author":[{"given":"Yasser","family":"Aljehani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atteia","family":"Alhouri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Turkistani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahma","family":"ShahBahai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah A.","family":"AlQatari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-47-20260114","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1111\/imj.12082","article-title":"Treatment of Raynaud phenomenon in systemic sclerosis","volume":"43","author":"Sinnathurai","year":"2013","journal-title":"Intern. 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