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Thoracic outlet syndrome after corrective surgery for pectus excavatum
1Department of Surgery, Stadsmaten Hospital, Enschede, The Netherlands.
The Netherlands Journal of Surgery
|February 1, 1988
Summary
Thoracic outlet syndrome (TOS) can occur after pectus excavatum surgery. Patients should be screened for latent TOS before surgery and monitored post-operatively to prevent neurovascular complications.
Area of Science:
- Cardiothoracic Surgery
- Vascular Surgery
- Neurology
Background:
- Pectus excavatum is a congenital chest wall deformity.
- Ravitch's operation is a surgical technique for pectus excavatum repair.
- Thoracic outlet syndrome (TOS) involves neurovascular compression in the thoracic outlet.
Observation:
- Two patients developed TOS following Ravitch's operation for pectus excavatum.
- One patient presented with acute TOS symptoms shortly after surgery.
- Another patient experienced a more gradual onset of TOS symptoms.
- A third patient had undiagnosed, latent TOS coexisting with pectus excavatum.
Findings:
- Ravitch's operation for pectus excavatum can precipitate or unmask thoracic outlet syndrome.
- Neurovascular compression symptoms may appear acutely or insidiously post-surgery.
- Latent TOS can be present in patients with pectus excavatum.
Implications:
- Preoperative screening for latent TOS is crucial in pectus excavatum patients.
- Postoperative vigilance for TOS development is necessary to prevent permanent nerve damage.
- Early detection and management of TOS can mitigate cervicobrachial plexus injury.