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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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Successful Return to Active Duty after First Rib Resection for Thoracic Outlet Syndrome.

Kimberly A Thompson1, Michael J Paisley2, Meghann E Nelles1

  • 1Naval Medical Center San Diego, Department of Surgery, San Diego, CA.

Annals of Vascular Surgery
|August 27, 2019
PubMed
Summary
This summary is machine-generated.

This study on thoracic outlet syndrome (TOS) found that first rib resection surgery in military patients led to high rates of vein patency and return to active duty. Individualized treatment approaches yielded successful outcomes.

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Area of Science:

  • Vascular Surgery
  • Thoracic Surgery
  • Military Medicine

Background:

  • Optimal surgical approaches for thoracic outlet syndrome (TOS) remain debated.
  • Military medical treatment facilities (MTFs) manage TOS patients, but outcomes data are limited.

Purpose of the Study:

  • To examine the outcomes of patients undergoing first rib resection (FRR) for TOS at a military MTF.
  • To assess patient demographics, surgical details, and functional recovery, including return to active duty (AD) status.

Main Methods:

  • Retrospective review of 33 FRRs performed on 32 patients over 9 years.
  • Analysis of patient demographics, perioperative data, and outcomes, focusing on AD status and return to duty.
  • Evaluation of surgical approaches (transaxillary, supraclavicular, paraclavicular) and treatments for venous, neurogenic, and arterial TOS.

Main Results:

  • 30 of 32 patients were on AD, with a mean age of 27 years.
  • 23 patients had venous TOS, 6 neurogenic, and 4 arterial.
  • Postoperative vein patency was 90% (18/20), and 89% (24/27) of patients returned to AD status.

Conclusions:

  • First rib resection demonstrated high rates of vein patency and return to AD status in a military population.
  • Individualized, multimodal treatment approaches and meticulous surgical technique are key to successful outcomes.
  • Despite varied approaches and delayed presentations, positive outcomes were achieved in this healthy military cohort.