Thoracic outlet syndrome--24 years of experience.
OBJECTIVE
Determine the outcomes of first rib resection for thoracic outlet syndrome.


BACKGROUND
Thoracic Outlet Syndrome is not a very frequent syndrome, affecting especially young patients, predominantly women. Its symptomatology is caused by compression of a nervous and vascular plexuses in a physiological isthmus in the upper thoracic aperture. Types of TOS can be neurogenic (95 %), arterial (3-5 %), or venous (2 %).


METHODS
Retrospective study was done at the 2nd Department of Surgery of St. Anne's University Hospital Brno, between the period 1982-2006, i.e. within 24 years. During this time 141 patients were operated on. Information gained was compared with the Czech vascular register.


RESULTS
Between 1982 and 2006, i.e. within 24 years, 141 patients were operated on. Out of a group of 100 patients in whom simple first rib resection was performed, re-operation after 2 years was necessary in 3 patients because of the same problems as before the operation (3 % of the patients). In these patients, symptoms occurred in 3-12 months after the first operation.


CONCLUSIONS
Initially, the treatment should always be conservative (rehabilitation), unless there is an acute vascular event. In case that rehabilitation treatment failed and the cause of TOS was proved, we recommend surgical treatment. Treatment of TOS is multidisciplinary (Fig. 2, Ref 8). Full Text (Free, PDF) www.bmj.sk
Podlaha
J
J
2nd Department of Surgery, St. Anne's Teaching Hospital, Masarykiensis University Brno, Czech Republic. jiri.podlaha@fnusa.cz
D005260:Female; D006801:Humans; D008297:Male; D012272:Ribs / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis / Q000601:surgery