title: Surgical decompression of thoracic outlet syndrome; is it a worthwhile procedure?
abstract: During a 20-year period from 1974 to 1994, 37 thoracic outlet decompressions were performed. There were 28 females and six males (ratio 5:1). The median age was 37 years (range 15-64). Symptoms were predominantly neurological in 29 limbs (78%), arterial in five limbs (14%) and venous in three limbs (8%). Limb pain and paraesthesia were the most common symptoms. Surgical decompression was performed via a supraclavicular approach in 24 limbs (65%) and a transaxillary approach in 13 limbs (35%). A cervical rib was excised in 21 limbs (57%), a first rib in 10 limbs (27%), a cervical and first rib in one limb (3%) and a cervical band in five limbs (13%). Arterial reconstruction was only required in three limbs (8%). There were a total of four complications (11%). The outcome of surgical decompression was assessed by using a questionnaire completed by the patient. Overall 27 patients (87%) felt that the operation was worthwhile. These results show that surgical decompression for thoracic outlet syndrome is a worthwhile procedure and is associated with relatively few complications.
authors.affiliation: Department of Surgery, Leicester General Hospital NHS Trust, UK.
authors.forename: A
authors.initials: A
authors.lastname: Nasim
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
authors.forename: P A
authors.initials: PA
authors.lastname: Healey
authors.forename: P R
authors.initials: PR
authors.lastname: Bell
authors.forename: W W
authors.initials: WW
authors.lastname: Barrie
mesh_terms: D000293:Adolescent; D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012272:Ribs / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000503:physiopathology / Q000601:surgery*