PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jrsocmedLink to Publisher's site
 
J R Soc Med. 1999 May; 92(5): 239–243.
PMCID: PMC1297175

Two-surgeon approach to thoracic outlet syndrome: long-term outcome.

Abstract

An orthopaedic surgeon and a vascular surgeon jointly conducted 30 operations for thoracic outlet syndrome in 27 patients, having done the preoperative assessments in conjunction with a neurologist. Anterior scalenectomy was performed by the supraclavicular route except in one case where the infraclavicular route was used. The further surgical procedure was tailored to the abnormalities identified--i.e. resection of cervical rib or band, or medial scalenectomy. The first rib was spared. At median follow-up of 37 months (range 3-228) results were judged excellent or good on 26/30 sides (87%); on the three occasions when scalenectomy alone was performed, the results were only fair or poor. There were no major complications and no patient required reoperation. The long-term outcome in this series suggests that, with multidisciplinary assessment and two-surgeon operative treatment, good results can be obtained by the supraclavicular route without resection of the first rib.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (722K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • PEET RM, HENRIKSEN JD, ANDERSON TP, MARTIN GM. Thoracic-outlet syndrome: evaluation of a therapeutic exercise program. Proc Staff Meet Mayo Clin. 1956 May 2;31(9):281–287. [PubMed]
  • Thompson JF, Jannsen F. Thoracic outlet syndromes. Br J Surg. 1996 Apr;83(4):435–436. [PubMed]
  • Crawford FA., Jr Thoracic outlet syndrome. Surg Clin North Am. 1980 Aug;60(4):947–956. [PubMed]
  • Kashyap VS, Ahn SS, Machleder HI. Thoracic outlet neurovascular compression: approaches to anatomic decompression and their limitations. Semin Vasc Surg. 1998 Jun;11(2):116–122. [PubMed]
  • Lindgren KA. Thoracic outlet syndrome with special reference to the first rib. Ann Chir Gynaecol. 1993;82(4):218–230. [PubMed]
  • Fantini GA. Reserving supraclavicular first rib resection for vascular complications of thoracic outlet syndrome. Am J Surg. 1996 Aug;172(2):200–204. [PubMed]
  • Schein CJ. A technic for cervical rib resection. Am J Surg. 1971 May;121(5):623–627. [PubMed]
  • Roos DB. The place for scalenectomy and first-rib resection in thoracic outlet syndrome. Surgery. 1982 Dec;92(6):1077–1085. [PubMed]
  • Roos DB. Congenital anomalies associated with thoracic outlet syndrome. Anatomy, symptoms, diagnosis, and treatment. Am J Surg. 1976 Dec;132(6):771–778. [PubMed]
  • Davies AH, Walton J, Stuart E, Morris PJ. Surgical management of the thoracic outlet compression syndrome. Br J Surg. 1991 Oct;78(10):1193–1195. [PubMed]
  • Loh CS, Wu AV, Stevenson IM. Surgical decompression for thoracic outlet syndrome. J R Coll Surg Edinb. 1989 Apr;34(2):66–68. [PubMed]
  • Brown SC, Charlesworth D. Results of excision of a cervical rib in patients with the thoracic outlet syndrome. Br J Surg. 1988 May;75(5):431–433. [PubMed]
  • Carty NJ, Carpenter R, Webster JH. Continuing experience with transaxillary excision of the first rib for thoracic outlet syndrome. Br J Surg. 1992 Aug;79(8):761–762. [PubMed]
  • Hempel GK, Rusher AH, Jr, Wheeler CG, Hunt DG, Bukhari HI. Supraclavicular resection of the first rib for thoracic outlet syndrome. Am J Surg. 1981 Feb;141(2):213–215. [PubMed]
  • Wood VE, Twito R, Verska JM. Thoracic outlet syndrome. The results of first rib resection in 100 patients. Orthop Clin North Am. 1988 Jan;19(1):131–146. [PubMed]
  • Ellison DW, Wood VE. Trauma-related thoracic outlet syndrome. J Hand Surg Br. 1994 Aug;19(4):424–426. [PubMed]
  • Hagberg M, Wegman DH. Prevalence rates and odds ratios of shoulder-neck diseases in different occupational groups. Br J Ind Med. 1987 Sep;44(9):602–610. [PMC free article] [PubMed]
  • Mandel S. Neurologic syndromes from repetitive trauma at work. Postgrad Med. 1987 Nov 1;82(6):87–92. [PubMed]
  • Carroll RE, Hurst LC. The relationship of thoracic outlet syndrome and carpal tunnel syndrome. Clin Orthop Relat Res. 1982 Apr;(164):149–153. [PubMed]
  • Atasoy E. Thoracic outlet compression syndrome. Orthop Clin North Am. 1996 Apr;27(2):265–303. [PubMed]
  • Baker DM, Lamerton AJ. Outcome of surgical management of the thoracic outlet compression syndrome in a district general hospital. Ann R Coll Surg Engl. 1993 May;75(3):172–174. [PMC free article] [PubMed]
  • Desai Y, Robbs JV. Arterial complications of the thoracic outlet syndrome. Eur J Vasc Endovasc Surg. 1995 Oct;10(3):362–365. [PubMed]
  • Edwards PR, Moody AP, Harris PL. First rib abnormalities in association with cervical ribs: a cause for postoperative failure in the thoracic outlet syndrome. Eur J Vasc Surg. 1992 Nov;6(6):677–681. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press