Surgery for paediatric thoracic outlet syndrome

The effectiveness of operative treatment of paediatric thoracic outlet syndrome (TOS) has been analysed, and an attempt made to improve the definition of the condition in terms of presentation, aetiology and diagnosis. A retrospective review of postoperative pain, functional capability and overall outcome was carried out on 13 patients (<18 years) treated by a single surgeon. In 20 operations, 17 were scalenotomies, and three were transaxillary rib resections (TARRs). Follow-up was 6-96 months post-operatively. Surgery alleviated many TOS symptoms, especially vascular compromise, although pain resolution was inconsistent and that of motor deficit poor. Mean functional improvement was good, and overall operative outcomes excellent. Therefore, surgery was successful for paediatric TOS in this series. Anatomical anomalies and sport participation may be related to early onset of TOS in many paediatric patients.