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Trans-axillary first rib excision for thoracic outlet syndrome
D P Edwards1, E Mulkern, A N Raja
1Department of Surgery, Royal Hospital Haslar, Gosport, Hants, UK.
Journal of the Royal College of Surgeons of Edinburgh
|December 29, 1999
Summary
Trans-axillary first rib excision effectively alleviates Thoracic Outlet Syndrome (TOS) symptoms in most patients. This study suggests TOS may be under-diagnosed, with a prevalence of at least 10 per 100,000 annually.
Area of Science:
- Vascular Surgery
- Neurosurgery
- Thoracic Surgery
Background:
- Thoracic Outlet Syndrome (TOS) is a condition often treated by first rib excision.
- Diagnosis typically involves symptoms and a positive Elevated Arm Stress Test.
- Surgical intervention aims to decompress the thoracic outlet.
Purpose of the Study:
- To evaluate symptom relief after trans-axillary first rib excision for TOS.
- To estimate the prevalence of Thoracic Outlet Syndrome.
Main Methods:
- Retrospective review of 52 trans-axillary first rib excisions in 46 patients.
- Inclusion criteria: TOS diagnosis suggested by positive Elevated Arm Stress Test.
- Post-operative symptom improvement confirmed diagnosis.
Main Results:
- 52 rib resections were performed over six years.
- 48 resections in 42 patients showed immediate symptom improvement; 3 patients had recurrence.
- Estimated TOS prevalence of at least 10 per 100,000 per year.
Conclusions:
- Trans-axillary first rib excision is an effective treatment for TOS.
- The frequency of TOS procedures suggests potential under-diagnosis of the condition.