Endoscopic assisted transaxillary first rib resection ☆

Abdellaoui, Adel; Atwan, Manal; Reid, Fergus; Wilson, Paul

doi:10.1510/icvts.2007.151423

Cited by 41 publications

(33 citation statements)

References 13 publications

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“…Brustwirbelkörper zieht. In ihrem nahezu horizontalen Verlauf unterschreitet sie das Gefäß-Nerven-Bündel, sodass zwischen Klavikula und 1 Wegen der dominanten Versorgungsaufgabe der A. subclavia verursacht eine arterielle Kompression eine "Claudicatio intermittens" des Arms. Steht eine solche arterielle Kompression im Vordergrund der Gesamtbeschwerden, dann können rasche Ermüdbarkeit, claudicatio-artige Schmerzen bei Überkopfarbeit, eine Blässe und Kälte der Hand als Leitsymptome gewertet werden.…”

Section: äTiologie Und Pathomechanismusunclassified

“…Weitere Zugangswege sind von paraskapulär, transklavikulär, supra-oder infraklavikulär gegeben, werden aber nicht so häufig verwendet, da Zusatzeingriffe wie oben beschrieben nicht ohne Probleme ohne einen weiteren Zugang durchgeführt werden kön-nen. Einen deutlichen Vorteil haben diese Zugangswege jedoch bei notwendigen Rezidiveingriffen [1,61].…”

Section: Operative Zugangswege Und Lagerung Des Patientenunclassified

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Thoracic-outlet-Syndrom

Dragu

Lang

Unglaub

et al. 2008

Chirurg

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The thoracic outlet syndrome (TOS) is a disputed syndrome in the field of the so-called compression syndromes of the upper extremity. This is no surprise, as the TOS is a complex and multifactorial compression syndrome diagnosed by different medical specialities. On average 6.5 physicians of different specialities need 4.3 years to come up with the diagnosis of TOS. The correct diagnosis is of great importance and crucial for successful operative treatment. The necessary diagnostic tests can only be accomplished by team work, especially interdisciplinary cooperation. This expressly includes physiotherapy and not just the medical disciplines. This contribution presents a summary of the approaches and interactions involved in effective diagnosis and treatment of TOS.

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Section: äTiologie Und Pathomechanismusunclassified

Section: Operative Zugangswege Und Lagerung Des Patientenunclassified

Thoracic-outlet-Syndrom

Dragu

Lang

Unglaub

et al. 2008

Chirurg

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“…Decompression may be achieved by resection of the first rib, freeing of scalene attachment, and resection of the cervical rib (if exists) (5,6). Starting from 1910 by Thomas Murphy (7), there had been several surgical approach variations (8) including posterior approach by Clagett (9), transaxillary approach by Roos (10) supraclavicular, axillary conventional approach by Hempel and Sanders (11).…”

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confidence: 99%

“…The technique has been described as using the video camera system for resecting the first rib in TOS patients (12). The use of VATS in TOS surgery had been described in different with or without using the pleural cavity (1,6,13).…”

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confidence: 99%

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Editorial on Totally endoscopic (VATS) first rib resection for thoracic outlet syndrome

Kara

2017

J. Thorac. Dis.

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Thoracic outlet syndrome: A neurological and vascular disorder

et al. 2013

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Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding structures. A combined supraclavicular and infraclavicular approach is preferred when a larger field of view is required. The future of TOS management must emphasize the improvement of available diagnostic and treatment techniques, and the development of a consensus gold standard for diagnosis. Helical computed tomography offers a three-dimensional view of the thoracic outlet, and may be valuable in the detection of anatomical variations, which may predispose patients to TOS. This review summarizes the history of TOS, the pertinent clinical and anatomical presentations of TOS, and the commonly used diagnostic and treatment techniques for the condition.

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Endoscopic assisted transaxillary first rib resection ☆

Abstract: Endoscopic assisted transaxillary first rib resection is a safe and effective procedure in the management of thoracic outlet syndrome. It also offers a great opportunity for teaching.

Cited by 41 publications

References 13 publications

Thoracic-outlet-Syndrom

Thoracic-outlet-Syndrom

Editorial on Totally endoscopic (VATS) first rib resection for thoracic outlet syndrome

Thoracic outlet syndrome: A neurological and vascular disorder

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