Journal article
Supraclavicular Versus Transaxillary First Rib Resection for Thoracic Outlet Syndrome
Journal of laparoendoscopic & advanced surgical techniques. Part A, Vol.30(7), pp.737-741
07/01/2020
DOI: 10.1089/lap.2019.0722
PMID: 32412829
Abstract
Background: Thoracic outlet syndrome (TOS) results from compression of neurovascular structures supplying the upper extremity as they exit the thoracic outlet. Depending on the clinical presentation, surgical decompression may be required.
Objectives: Transaxillary (TA) and supraclavicular (SC) approaches are both widely utilized and deemed effective. Our objective was to review the outcomes for both approaches at our institution.
Methods: A retrospective review was conducted on patients who underwent thoracic outlet decompression between 2010 and 2015. Data on demographics, comorbidities, presenting symptoms, and type of TOS (neurogenic, venous, or arterial) were collected. Operative times, length of hospital stay, perioperative complications, and outcomes were also studied.
Results: A total of 82 thoracic outlet decompression procedures were performed during the study period: 42% neurogenic TOS, 46% venous TOS, and 12% arterial TOS. In total, 49% underwent TA approach and 51% underwent SC approach. Adjunct procedures were performed in 13% of patients. There were no significant differences in average operative time (151.3 +/- 54.1 minutes versus 126.1 +/- 36.1 minutes, P = .11) or hospital stay (2.3 +/- 1.9 days versus 2.4 +/- 1.4 days, P = .23) between both groups, respectively. Minor complications were seen in 6% of patients with no significant difference in both groups, whereas 6% had major complications. No perioperative or 30-day mortalities were observed. In total, 49% of patients had complete resolution of symptoms, 46% had partial improvement, and 5% had no improvement. There was no difference in symptom resolution between either group.
Conclusions: TA and SC approaches are equally safe and effective for the treatment of TOS. SC decompression allows for adjunct procedures and vascular reconstructions.
Details
- Title: Subtitle
- Supraclavicular Versus Transaxillary First Rib Resection for Thoracic Outlet Syndrome
- Creators
- Maen Aboul Hosn - Univ Iowa Hosp & Clin, Div Vasc Surg, Iowa City, IA 52242 USAPaolo Goffredo - University of IowaJeanette Man - University of Iowa Hospitals and ClinicsRachael Nicholson - University of IowaTimothy Kresowik - University of Iowa Hospitals and ClinicsMelhem Sharafuddin - University of IowaWilliam J. Sharp - University of IowaLuigi Pascarella - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- Journal of laparoendoscopic & advanced surgical techniques. Part A, Vol.30(7), pp.737-741
- Publisher
- Mary Ann Liebert, Inc
- DOI
- 10.1089/lap.2019.0722
- PMID
- 32412829
- ISSN
- 1092-6429
- eISSN
- 1557-9034
- Number of pages
- 5
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Radiology; Surgery
- Record Identifier
- 9984322808302771
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