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[Cervico-thoracic outlet compression syndrome].

R Prêtre¹, R Mégevand

¹Clinique de chirurgie thoracique, Hôpital cantonal universitaire, Genève.

Helvetica Chirurgica Acta

|October 1, 1990

Summary

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This study compared transaxillary and transthoracic first rib resection for thoracic outlet syndrome. The transthoracic approach showed similar symptom improvement but with a lower risk of brachial plexus injury.

Area of Science:

Neurosurgery
Thoracic Surgery
Vascular Surgery

Background:

Thoracic outlet syndrome (TOS) is a condition caused by compression of neurovascular structures.
First rib resection is a common surgical treatment for TOS.
Two primary surgical approaches exist: transaxillary and transthoracic.

Purpose of the Study:

To compare the efficacy and safety of transaxillary versus transthoracic first rib resection for TOS.
To evaluate patient outcomes and complication rates for each surgical approach.

Main Methods:

Retrospective comparative study of patients undergoing first rib resection for TOS.
Analysis of outcomes including symptom improvement, unchanged symptoms, and worsening of symptoms.
Assessment of complication rates, specifically brachial plexus injury.

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Main Results:

Transaxillary approach (13 cases): 84% improved, 8% unchanged, 8% worse; one permanent brachial plexus injury.
Transthoracic approach (18 cases): 87% improved, 13% unchanged; no permanent brachial plexus injuries, mild paresthesia in two patients.
Both approaches yielded similar symptom improvement rates.

Conclusions:

Transaxillary and transthoracic first rib resection offer comparable outcomes for TOS symptom management.
The transthoracic approach appears to be a safer alternative due to a reduced risk of brachial plexus injury.
The transthoracic approach is recommended for first rib resection in TOS treatment.