Video-assisted thoracoscopic surgery for intrathoracic first rib resection in thoracic outlet syndrome

Hwang, Jinwook; Min, Byung Ju; Jo, Won Min; Shin, Jae Seung

doi:10.21037/jtd.2017.06.122

Cited by 32 publications

(19 citation statements)

References 26 publications

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“…As noted above, first rib resection with scalenectomy remains the operation of choice for decompression, but as surgical advancements continue to emphasize minimally invasive approaches, some institutions now employ VATS in order to achieve a clearer visualization of the operative field and potentially minimize injury to the neurovascular bundle [61]. Two additional strategies, the robotic-assisted and endoscopic-assisted trans-axillary approaches, are novel techniques with potential benefit, the latter aiming to decrease risk of pneumothorax [56].…”

Section: Recent Developmentsmentioning

confidence: 99%

Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment

et al. 2019

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Thoracic outlet syndrome, a group of diverse disorders, is a collection of symptoms in the shoulder and upper extremity area that results in pain, numbness, and tingling. Identification of thoracic outlet syndrome is complex and a thorough clinical examination in addition to appropriate clinical testing can aide in diagnosis. Practitioners must consider the pathology of thoracic outlet syndrome in their differential diagnosis for shoulder and upper extremity pain symptoms so that patients are directed appropriately to timely therapeutic interventions. Patients with a definitive etiology who have failed conservative management are ideal candidates for surgical correction. This manuscript will discuss thoracic outlet syndrome, occurrence, physical presentation, clinical implications, diagnosis, and management.

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Section: Recent Developmentsmentioning

confidence: 99%

Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment

et al. 2019

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“…Rib resections carry an inherent risk of neurovascular injury due to poor visualization and incomplete resection [ 101 , 102 , 103 ]. The use of robotically assisted endoscopic cameras allows for improved visualization of the first rib and the neurovascular bundle, although it is unclear whether this procedure is correlated with stronger symptomatic and postoperative outcomes [ 101 ].…”

Section: Surgical Managementmentioning

confidence: 99%

Thoracic Outlet Syndrome: A Narrative Review

Dierks

Vervaeke

et al. 2021

JCM

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Thoracic outlet syndrome comprises a group of disorders that result in compression of the brachial plexus and subclavian vessels exiting the thoracic outlet. Symptoms include pain, paresthesia, pallor, and weakness depending upon the compromised structures. While consensus in diagnostic criteria has not yet been established, a thorough patient history, physical exam, and appropriate imaging studies are helpful in diagnosis. General first-line therapy for thoracic outlet syndrome is a conservative treatment, and may include physical therapy, lifestyle modifications, NSAIDs, and injection therapy of botulinum toxin A or steroids. Patients who have failed conservative therapy are considered for surgical decompression. This article aims to review the epidemiology, etiology, relevant anatomy, clinical presentations, diagnosis, and management of thoracic outlet syndrome.

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“…A separate incision is often used for release of the pectoralis minor tendon for patients with evidence of compression at that level [24]. Minimally invasive approaches, utilizing an extrapleural approach with video assistance (thorascopic), have been popularized, but this still remains experimental without any clear advantages over standard surgical approaches [25]. Of the standard surgical approaches, there is some evidence to suggest that the recurrence rate with the supraclavicular approach is lower than with the transaxillary approach, particularly in long-term follow-up [26].…”

Section: Treatmentmentioning

confidence: 99%

Thoracic Outlet Syndrome in the Overhead Athlete: Diagnosis and Treatment Recommendations

Ohman

Thompson

2020

Curr Rev Musculoskelet Med

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Purpose of Review Neurovascular compression in the upper extremity is rare but can affect even those participating in high-level competitive athletics. To assess optimal approaches to treatment, in this review, we evaluate the current literature on neurovascular compressive syndromes affecting the upper extremity, with a special focus on the thoracic outlet syndrome (TOS). Recent Findings Neurovascular compression at the thoracic outlet can involve the brachial plexus, subclavian artery, or subclavian vein, each with distinct clinical manifestations. Neurogenic TOS is best treated with surgical decompression, if physical therapy has not improved symptoms. Venous TOS results in acute thrombosis superimposed on chronic venous compression. Treatment is best directed at early anticoagulation, catheter-directed thrombolysis, and surgical decompression, with most patients able to discontinue anticoagulation and return to high-level athletic activity. Arterial TOS is related to aneurysmal degeneration of the subclavian artery with distal embolization, leading to limb-threatening ischemia. This should be aggressively treated with surgery. Similar degenerative changes can occur in the axillary artery and its branches, leading to distal embolization. Prompt recognition of these potential sources of limb-threatening ischemia is critical to limb preservation. Summary TOS includes rare but important conditions in the overhead athlete. Recent advances in physical therapy and imageguided diagnostic techniques have facilitated more accurate diagnosis. Surgical treatment remains the gold standard to maximize function or for limb preservation, and future research is needed to clarify optimal pain and physiotherapy regimens, as well as to examine novel approaches to neurovascular decompression.

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Video-assisted thoracoscopic surgery for intrathoracic first rib resection in thoracic outlet syndrome

Abstract: VATS-IFRR was safe and had several advantages. Thus, VATS-IFRR is a minimally invasive surgical option suitable for treating selective cases of TOS.

Cited by 32 publications

References 26 publications

Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment

Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment

Thoracic Outlet Syndrome: A Narrative Review

Thoracic Outlet Syndrome in the Overhead Athlete: Diagnosis and Treatment Recommendations

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