Transaxillary Approach for Upper Thoracic Sympathetic Ganglionectomy

Crandell, Walter B.; Bosien, William Riley

doi:10.1097/00000658-195507000-00004

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…Walter et al done a study on the transaxillary approach for upper limb sympathectomy on 11 patients, out of 11 patients 4 got transient pleural effusion, three patients experienced pneumothorax, one patient got winging of scapula. 23 In our study, none of our patient developed pleural effusion or hemothorax or pneumothorax or winging of scapula.…”

Section: Discussionmentioning

confidence: 42%

“…In 1962, Ross introduced trans axillary approach for first rib excision for thoracic outlet syndrome, since then trans axillary approach was popularized in general surgeons for breast surgery, ENT surgeons for thyroidectomy, vascular surgeons for vascular surgery and neurosurgeons utilized it most commonly for TOS also for sympathectomy procedures. 17,18 Our surgical technique trans axillary and transthoracic approach is the modification of two techniques the traditional trans axillary and transthoracic approach, in traditional trans axillary approach transverse 7-9 cm of incision is given at the root at axillary fold where as in our approach its 6-7 oblique incision along anterior border of the latissimus dorsi. In transthoracic, pathology was accessed through 4 or 5 ribs, where as we entered from 3 rd rib.…”

Section: Discussionmentioning

confidence: 99%

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Transaxillary Transthoracic Approach to Upper Dorsal Spine Lesions: An Anatomical Corridor with Muscle Preservation

et al. 2020

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Objective: Conventional methods for anterior upper dorsal spine are not devoid of intra-operative complications due to anatomical constraints, a major blood vessel and vital organs. We analyzed the details of Trans- axillary approach without muscle cutting in tuberculosis, tumor, and traumatic lesions of T2 to T6 and upper limb causalgia.Materials and Methods: A prospective quasi-experimental study was conducted for 3 years included 30 patients presented with dorsal myelopathy due to D2 to D6 vertebral body involvement. Right and left sided approaches were utilized. Medical Research Council grading was used to assess neurological status.Results: Mean age was 32 ± 15 years, which included male 18.60% and female 12.40%. T4 vertebrae were commonly involved. Others were T5, T3 and T6 respectively. The majority of lesions were tuberculosis of the spine (n = 14), tumor (n = 8), trauma (n = 5) and causalgia of upper limb (n = 3). No intra-operative complications occurred, estimated blood was 80-100 ml and operative time was 120-160 minutes. Postoperative complications included pneumonia (n = 1), superficial wound infection (n = 3), death (n = 1). Serial follow up was for 2 years, Patients were discharged with improved neurological status and causalgia patients got immediate post-operative relief.Conclusions: Transaxillary approach is a unique anatomical corridor which is safe, feasible with promising results. It provides optimal decompression, reconstruction with better fixation and alignment in various pathologies of upper dorsal spine.

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Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Transaxillary Transthoracic Approach to Upper Dorsal Spine Lesions: An Anatomical Corridor with Muscle Preservation

et al. 2020

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“…Urschel [ 23 ] introduced the transaxillary approach not for spinal pathology but for rib resection in thoracic outlet syndrome. This was then popularized by vascular surgeons to address vascular lesions and by neurosurgeons to perform sympathectomy [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Transaxillary Approach as a Direct Route in the Management of Upper Thoracic Spine Pathology: A Technical Note with Case Series

Ifthekar,

Seuk,

Hwang

et al. 2024

Asian Spine J

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This retrospective case series of prospective data aims to describe the transaxillary approach for the treatment of upper thoracic spine pathology. Various surgical techniques and approaches have been reported across the literature to address upper thoracic spine pathology, including the cervicothoracic approach, anterior transsternal approach, posterolateral approach, supraclavicular approach, and lateral parascapular approaches. These techniques are invasive. A minimally invasive, less morbid, and direct access approach to the pathology of the upper thoracic spine has not been reported in the literature. Patients with pathology affecting the first thoracic vertebra up to the sixth thoracic vertebra were classified into the upper thoracic spine group. Patients with pathology below the sixth thoracic vertebra were excluded. Patients not having a minimum follow-up of 12 months were also excluded. The study analyzed 18 patients. The mean preoperative modified Japanese Orthopedic Association score was 7.2±1.44, which improved to 10.16±1.2 (p<0.05). The majority (14/18) of the patients had an excellent outcome. Three patients had good outcomes, and one patient had a fair outcome. Five cases of intraoperative dural leak were recorded, and one patient had postoperative neurological deficit. The transaxillary approach is a safe, viable, muscle-sparing, and minimally invasive approach for ventral pathologies of the upper thoracic spine.

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Extrapleural Posterolateral Approach for Upper Thoracic Sympathectomy

Crowley¹,

Economy²

1957

AMA Arch Surg

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Transaxillary Approach for Upper Thoracic Sympathetic Ganglionectomy

Cited by 4 publications

References 2 publications

Transaxillary Transthoracic Approach to Upper Dorsal Spine Lesions: An Anatomical Corridor with Muscle Preservation

Transaxillary Transthoracic Approach to Upper Dorsal Spine Lesions: An Anatomical Corridor with Muscle Preservation

The Transaxillary Approach as a Direct Route in the Management of Upper Thoracic Spine Pathology: A Technical Note with Case Series

Extrapleural Posterolateral Approach for Upper Thoracic Sympathectomy

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