Abstract
This follow-up study on 33 operations performed for thoracic outlet syndrome (TOS)
proves high efficiency in relieving neurological and arterial symptoms, whereas benefit
to venous compression is somewhat less. Twenty-six patients (average age was 36 years)
were operated on for TOS, seven of them on both sides. There was a higher incidence
in females. All patients showed neurological symptoms. In 15, operations on various
entrapment syndromes of the upper extremity were performed previously. Six patients
presented with an incomplete resection of the first rib. Arterial compression symptoms
were evident in 15 cases, symptoms of venous compression in 14 limbs. All patients
underwent a resection of the first rib, bilateral in seven cases, using the axillary
and supraclavicular approach. In seven patients, a cervical rib and scalenus muscles
were resected additionally, in three patients bilaterally. In two cases a neurolysis
of the brachial plexus was performed. Using the supraclavicular approach, no complications
occurred. In one early patient using the transaxillary approach to a postoperative
hemothorax required a revision. Neurological results after surgery showed a total
release in 26 limbs (n = 33). In 14 limbs (n = 15) with arterial compression symptoms
and in 6 (n = 14) with symptoms of venous compression the operation showed a curative
effect.
