COMPRESSION SYNDROME OF THE THORACIC OUTLET SYNDROME

This retrospective study compares the results of two surgical procedures, a transaxillary and a transthoracic (i.e. antero-lateral thoracotomy) approach, in the treatment of the thoracic outlet syndrome by first rib resection. Following transaxillary first rib removal (13 cases), initially our procedure of choice, 84% of patients had symptoms improved, 8% were unchanged and 8% were worse after one year. One permanent, disabling brachial plexus injury occurred after this operation. Transthoracic first rib resection (18 cases), presently our preferred technique, resulted in improvement in 87% of cases, with 13% of symptoms unchanged after one year. While two female patients felt mild paresthesia of their mammary gland, no one has been made worse following this route. These two approaches have achieved similar results in the surgical management of this syndrome. Nevertheless, when first rib resection is indicated, our favored and recommended procedure is the transthoracic one, as this appears less hazardous for brachial plexus damage.