Surgical treatment of thoracic outlet syndrome in pediatrics

Boglione, Mariano; Ortiz, Ramiro Jorge; Teplisky, Darío; Giuseppucci, Carlos; Korman, Luciano; Reusmann, Aixa; Barrenechea, Marcelo

doi:10.1016/j.jpedsurg.2021.08.017

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Консервативное лечение, включающее в себя лечебную физкультуру, физиотерапию и прием лекарственных препаратов, может давать хорошие результаты [6]. При неэффективности консервативного лечения применяют хирургические методы, которые заключаются в устранении причины механической компрессии в области грудной апертуры: удаление рубцовых тканей; резекция добавочного ребра, остеофитов; миотомия подключичной мышцы [7][8][9][10]. Хирургическое вмешательство выполняется, как правило, открытым доступом, что сопровождается значительной кровопотерей и травматизацией мягких тканей и имеет риск осложнений (инфекционный процесс, послеоперационная гематома) [11,12].…”

Section: обоснованиеunclassified

A clinical case of a combined endoscopic treatment: brachial plexus decompression in the thoracic aperture and subacromial spacer implantation

Belyak

Paskhin

Lazko

et al. 2022

Journal of Clinical Practice

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Relevance. Thoracic outlet syndrome compression of brachial plexus in the area between clavicle and first rib is a commonly spread and relevant pathology. It occurs, as usual, after trauma or because of anatomical malformation of this area. Thoracic outlet syndrome can combine with shoulder joint pathology. In case of conservative treatment failure standard surgical procedure is decompression of brachial plexus in thoracic aperture. This procedure is usually done by open approach. Development of endoscopic surgical technique of decompression allows decrease the risk of complication and recurrences, improve the cosmetic result and relieve rehabilitation period. Goal. Report the clinical case and evaluate the results after shoulder arthroscopy and endoscopic brachial plexus decompression in thoracic aperture at 6 months follow-up. Material and methods. 73 years-old female patient with clinical picture of posttraumatic brachial plexopathy and massive shoulder rotator cuff tear. The patient underwent conservative treatment for 6 months after trauma without significant improvement. For confirming the diagnosis ENMG and ultrasound investigation of brachial plexus, MRI of shoulder joint were performed. Simultaneous shoulder joint arthroscopy with subacromial spacer implantation and brachial plexus decompression in thoracic aperture were performed to the patient. Results. According to VAS-scale the severity of pain syndrome before the surgery was 10 cm., 6 months after the surgery decreased to 1 cm. According to DASH scale the dysfunction of the of shoulder joint before the surgery was 76 points, 6 months after the surgery decreased to 12 points. Range of motion in the shoulder joint before the surgery was: flexion 105, abduction 95, external rotation 15; 6 months after the surgery: 160, abduction 165, external rotation 45. Conclusion. The results do let us characterize the method of simultaneous shoulder joint arthroscopy and endoscopic decompression of brachial plexus in thoracic aperture as a low-traumatic and effective technique, which promotes restoration of function of upper extremity and shoulder joint, elimination of pain syndrome from upper extremity area, allowing to perform complete brachial plexus decompression in thoracic aperture.

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Section: обоснованиеunclassified

A clinical case of a combined endoscopic treatment: brachial plexus decompression in the thoracic aperture and subacromial spacer implantation

Belyak

Paskhin

Lazko

et al. 2022

Journal of Clinical Practice

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“…Treating priorities with rehabilitation training and analgesia can significantly improve outcomes for most patients (3)(4)(5). Surgical treatment may be considered for patients whose conservative treatment was not effective or worsened for more than 6 months (6). Most clinicians believe that surgery has a positive effect on the rapid recovery of the upper limb, pain relief, and low recurrence (7).…”

Section: Introductionmentioning

confidence: 99%

Derkash's Classification and Vas Visual Analog Scale to Access the Long-Term Outcome of Neurothoracic Outlet Syndrome: A Meta-Analysis and Systematic Review

et al. 2022

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ObjectiveMany publications report outcomes of surgical treatment for neurothoracic outlet syndrome (NTOS); however, high-quality meta-analyses regarding objective evaluation system accessing the long-term outcome of NTOS are lacking. This meta-analysis summarizes and compares the outcomes of Derkosh's classification and vas visual analog scale of the supraclavicular neuroplastic of brachial plexus (SNBP) and trams auxiliary first rib resection (TFRR).MethodsThe Cochrane Library, PubMed, EMBASE, Allied and Complementary Medicine (AMED) were searched for papers published between January 1980 and February 2021, using the keywords “thoracic outlet syndrome,” “treatment, surgical.” Articles were eligible for inclusion if the following criteria were met studies describing outcomes of surgery for NTOS, published in English, human studies, and available in full text. The exclusion criteria were case reports (n < 10), reviews, abstracts, and studies lacking a control group or without evaluation for two types of surgery.ResultsWe included 10 studies with 1,255 cases, out of which 622 were in the SNBP group; and 633 were in the TFRR group. After surgery (≥12 months), Derkash's classification was improved in 425 cases with SNBP and 364 cases with TFRR. OR = 1.34 (95% CI: 0.94, 1.92), P = 0.03; vas visual analog scale was improved in 282 cases in the SNBP group and 214 cases in the TFRR group. OR = 1.08 (95% CI: 0.63, 1.85), P = 0.78.ConclusionThis meta-analysis shows that both SNBP and TFRR are effective for NTOS, but that SNBP is better than TFRR in improving Derkash's classification in the long term. Although patients treated with SNBP are more satisfactory, there is no significant difference in vas visual analog scale from TFRR.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021254203, PROSPERO CRD42021254203.

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Systematic review of intermediate and long-term results of thoracic outlet decompression

Khoury,

Thornton,

Dua

2024

Seminars in Vascular Surgery

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Surgical treatment of thoracic outlet syndrome in pediatrics

Cited by 3 publications

References 23 publications

A clinical case of a combined endoscopic treatment: brachial plexus decompression in the thoracic aperture and subacromial spacer implantation

A clinical case of a combined endoscopic treatment: brachial plexus decompression in the thoracic aperture and subacromial spacer implantation

Derkash's Classification and Vas Visual Analog Scale to Access the Long-Term Outcome of Neurothoracic Outlet Syndrome: A Meta-Analysis and Systematic Review

Systematic review of intermediate and long-term results of thoracic outlet decompression

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