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Updated: Sep 29, 2026
Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Neurogenic thoracic outlet syndrome treatment by the supraclavicular approach
1Department of Thoracic and Vascular Surgery, Diayala Teaching Hospital, Diayala, Iraq.
Background:
Thoracic outlet syndrome refers to compression of one or more of the neurovascular structures traversing the superior aperture of the thoracic cavity.
Objective:
A symptom-based patient-directed questionnaire was used to evaluate the outcome of the supraclavicular approach for treatment of neurogenic thoracic outlet syndrome.
Patients And Methods:
A prospective study was performed between April 2007 and October 2010. During this period, 97 patients in different age groups, with signs and symptoms of thoracic outlet syndrome, were surgically treated by the supraclavicular approach. The patients were aged between 14 and 60 years (mean 32.5 years), and the majority were female (89.69%). Surgery was performed on the left side in 52 patients and on the right side in 48, including 3 who had bilateral operations. The median follow-up was 11.2 months.
Results:
In 78% of the 100 operations, excellent improvement in symptoms was noted, there was partial improvement in 18%, and 4% resulted in no response.
Conclusions:
First rib resection remains an important and essential step in the management of the thoracic outlet syndrome, in the absence of bony abnormalities. The supraclavicular approach can be employed with minimal morbidity and an excellent outcome.
