Thirty-year experience of transaxillary resection of first rib for thoracic outlet syndrome

Stilo, Francesco; Montelione, Nunzio; Benedetto, Filippo; Spinelli, Domenico; Vigliotti, Rossella Chiara; Spinelli, Francesco

doi:10.23736/s0392-9590.19.04300-1

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…In the surgical treatment of thoracic outlet syndrome, the most commonly used intervention since the 1960s is transaxillary intervention. It can easily reach the first rib, cervical rib and neurovascular structures, and protection of neurovascular structures can be achieved during the removal of the first rib [4,9,15]. We too have performed transaxillary intervention on all of the cases in our operations and we performed first rib resection and scalenectomy in all cases.…”

Section: Discussionmentioning

confidence: 99%

Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

Aslaner¹

2020

Acta Medica Alanya

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Amaç: Bu çalışmada, Torasik outlet sendromu tanısı konulan hastalarda cerrahi tedavinin etkinliğini değerlendirmeyi amaçladık. Hastalar ve Yöntem: 1991 ile 2004 yılları arasında Torasik Outlet Sendromu tanısı almış ve tedavi yöntemi olarak cerrahi uygulanmış otuz yedi olgunun yaş, cins, meslek dağılımı, anamnez ve fizik muayene bulguları, semptomları, preoperatif tetkikleri, operasyon bulguları, postoperatif komplikasyonları, postoperatif hastanede kalış süreleri ve operasyon sonuçlan incelenerek yapıldı. Bulgular: Olguların çoğu 15-35 yaş grubunda (% 72.97) ve kadınlardan (% 91,9) oluşmaktaydı. Bu olguların çoğu ev hanımıydı (% 51.4). En sık rastlanılan semptomlar ağrı (%94,6) ve uyuşma (% 78.4) idi. Fizik muayenede en sık kullanılan test Adson testi idi. Adson testi %86 oranında pozitif bulundu. Radyolojik testlerde en sık karşılaşılan patoloji servikal kosta anomalisiydi (% 37.8). üst ekstremite EMG sinin %48.6, üst ekstremite arteriel doplerinde% 13.5 oranında TOS u desteklediği bulundu. Cerrahide transaksiller girişim ile birinci kosta ve servikal kosta rezeksiyonu. skalenektomi fibromüsküler bantların kesilmesi işlemlerini uyguladık. Cerrahiden sonra erken dönemde %78.4 oranında tam düzelme görüldü. Olguların hiçbirinde mortalite olmadı. Sonuç: Bu çalışmada TOS hastalarda, uygun olgularda ve iyi cerrahi teknik ile sonuçlar tatmin edici bulundu. Cerrahi başarı oranı %97 lere kadar çıkabilmektedir.

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Section: Discussionmentioning

confidence: 99%

Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

Aslaner¹

2020

Acta Medica Alanya

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“…While the most frequent type of TOS is neurogenic, and arterial and venous TOSs are relatively uncommon, they can coexist and possibly overlap [ 6 ]. Clinicians frequently have difficulty in categorizing them clearly, especially in cases with cervical spondylotic lesions.…”

Section: Discussionmentioning

confidence: 99%

Upper limb gangrene due to a subclavian arterial thrombosis associated with thoracic outlet syndrome following cervical spondylotic amyotrophy

Yamada

Kudo

Kawabata

et al. 2021

Journal of Surgical Case Reports

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Thoracic outlet syndrome (TOS) refers to an abnormal compression of the subclavian vessels and the brachial plexus at the base of the neck or thoracic outlet. The authors described a novel case of a 66-year-old male with arterial TOS and unilateral upper rib dysplasia following cervical spine disease. Owing to the comorbidity of cervical spondylotic amyotrophy and a history of sloping shoulder due to rib dysplasia, TOS occurred, which subsequently led to subclavian arterial thrombosis and eventually resulted in the gangrene of the hand. Thrombectomy and surgical resection of the first and second ribs avoided the progression of further neurovascular disorder. When treating a cervical spondylotic patient, concurrent TOS can be obscured by symptoms caused by cervical lesions, leading to difficulty in identifying the origin of these neurovascular findings. The possibility of subsequent thromboembolic events based on TOS should be considered, especially in cases with dysplasia of the upper ribs.

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“…Many authors think that resection of the first rib, with cervical rib when present, is best performed through the trans-axillary approach (see Section 5, Supplementary Material ) for complete removal with subclavian vascular decompression, while the supraclavicular approach (see Section 6, Supplementary Material ) is often preferred in nTOS, but may be appropriate in any combinations of these clinical syndromes ( 50 , 51 ).…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…In properly selected patients, clinical results of first rib resection may be considered good (complete relief of symptoms) in 85% of patients, fair (improvement with some residual or recurrent mild symptoms) in 10% and poor (no change from preoperative status) in 5% ( 50 , 52 , 53 ).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Diagnostic and Therapeutic Management of the Thoracic Outlet Syndrome. Review of the Literature and Report of an Italian Experience

Camporese

Bernardi

Venturin

et al. 2022

Front. Cardiovasc. Med.

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The Thoracic Outlet Syndrome is a clinical potentially disabling condition characterized by a group of upper extremity signs and symptoms due to the compression of the neurovascular bundle passing through the thoracic outlet region. Because of the non-specific nature of signs and symptoms, to the lack of a consensus for the objective diagnosis, and to the wide range of etiologies, the actual figure is still a matter of debate among experts. We aimed to summarize the current evidence about the pathophysiology, the diagnosis and the treatment of the thoracic outlet syndrome, and to report a retrospective analysis on 324 patients followed for 5 years at the Padua University Hospital and at the Naples Fatebenefratelli Hospital in Italy, to verify the effectiveness of a specific rehabilitation program for the syndrome and to evaluate if physical therapy could relieve symptoms in these patients.

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Thirty-year experience of transaxillary resection of first rib for thoracic outlet syndrome

Cited by 13 publications

References 21 publications

Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

Upper limb gangrene due to a subclavian arterial thrombosis associated with thoracic outlet syndrome following cervical spondylotic amyotrophy

Diagnostic and Therapeutic Management of the Thoracic Outlet Syndrome. Review of the Literature and Report of an Italian Experience

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