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Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome

BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In thi...

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Autores principales: Hosseinian, Mohammad Ali, Loron, Ali Gharibi, Soleimanifard, Yalda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Thoracic and Cardiovascular Surgery 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295481/
https://www.ncbi.nlm.nih.gov/pubmed/28180101
http://dx.doi.org/10.5090/kjtcs.2017.50.1.36
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author Hosseinian, Mohammad Ali
Loron, Ali Gharibi
Soleimanifard, Yalda
author_facet Hosseinian, Mohammad Ali
Loron, Ali Gharibi
Soleimanifard, Yalda
author_sort Hosseinian, Mohammad Ali
collection PubMed
description BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. METHODS: In this study, 448 patients with symptoms of TOS were assessed. The male-to-female ratio was approximately 1:4, and the mean age was 34.5 years. Overall, 102 operations were performed, including unilateral, bilateral, and reoperations, and the patients were retrospectively evaluated. Of the 102 patients, 63 underwent the supraclavicular approach, 32 underwent the transaxillary approach, and 7 underwent the transaxillary approach followed by the supraclavicular approach. Complications were evaluated over 24 months. RESULTS: The prevalence of pneumothorax, hemothorax, and vessel injuries in the transaxillary and the supraclavicular approaches was equal. We found more permanent and transient brachial plexus injuries in the case of the transaxillary approach than in the case of the supraclavicular approach, but the difference was not statistically significant. Persistent pain and symptoms were significantly more common in patients who underwent the transaxillary approach (p<0.05). CONCLUSION: The supraclavicular approach seems to be the more effective technique of the two because it offers the surgeon better access to the brachial plexus and a direct view. This approach for a TOS operation offers a better surgical outcome and lower reoperation rates than the transaxillary method. Our results showed the supraclavicular approach to be the preferred method for TOS operations.
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spelling pubmed-52954812017-02-08 Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome Hosseinian, Mohammad Ali Loron, Ali Gharibi Soleimanifard, Yalda Korean J Thorac Cardiovasc Surg Clinical Research BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. METHODS: In this study, 448 patients with symptoms of TOS were assessed. The male-to-female ratio was approximately 1:4, and the mean age was 34.5 years. Overall, 102 operations were performed, including unilateral, bilateral, and reoperations, and the patients were retrospectively evaluated. Of the 102 patients, 63 underwent the supraclavicular approach, 32 underwent the transaxillary approach, and 7 underwent the transaxillary approach followed by the supraclavicular approach. Complications were evaluated over 24 months. RESULTS: The prevalence of pneumothorax, hemothorax, and vessel injuries in the transaxillary and the supraclavicular approaches was equal. We found more permanent and transient brachial plexus injuries in the case of the transaxillary approach than in the case of the supraclavicular approach, but the difference was not statistically significant. Persistent pain and symptoms were significantly more common in patients who underwent the transaxillary approach (p<0.05). CONCLUSION: The supraclavicular approach seems to be the more effective technique of the two because it offers the surgeon better access to the brachial plexus and a direct view. This approach for a TOS operation offers a better surgical outcome and lower reoperation rates than the transaxillary method. Our results showed the supraclavicular approach to be the preferred method for TOS operations. The Korean Society for Thoracic and Cardiovascular Surgery 2017-02 2017-02-05 /pmc/articles/PMC5295481/ /pubmed/28180101 http://dx.doi.org/10.5090/kjtcs.2017.50.1.36 Text en Copyright © 2017 by The Korean Society for Thoracic and Cardiovascular Surgery. All rights Reserved. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Research
Hosseinian, Mohammad Ali
Loron, Ali Gharibi
Soleimanifard, Yalda
Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title_full Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title_fullStr Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title_full_unstemmed Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title_short Evaluation of Complications after Surgical Treatment of Thoracic Outlet Syndrome
title_sort evaluation of complications after surgical treatment of thoracic outlet syndrome
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295481/
https://www.ncbi.nlm.nih.gov/pubmed/28180101
http://dx.doi.org/10.5090/kjtcs.2017.50.1.36
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