McCarthy M J, Varty K, London N J, Bell P R
Department of Surgery, University of Leicester, UK.
Ann Vasc Surg. 1999 May;13(3):268-74. doi: 10.1007/s100169900256.
The purpose of this study was to assess the symptomatic outcome of patients with thoracic outlet syndrome who underwent decompression of the thoracic outlet. In our unit we prefer the supraclavicular approach, performing anterior scalenectomy with excision of fibrous bands or cervical ribs if present. Operative details were gained by theater logbook and case note review. Over a 6-year period, 31 patients (37 limbs) underwent thoracic outlet decompression. Of the 37 affected limbs, the indications for surgery were a combination of both neurological and vascular symptoms in 24 patients (65%), neurological symptoms in 24 (65%), and 4 patients (11%) had vascular symptoms alone. All patients were assessed for postoperative outcome either at out-patient clinics or by personal contact. From the results of this study we concluded that supraclavicular scalenectomy and cervical rib excision with selective first rib excision is a safe and effective procedure for most patients with thoracic outlet syndrome.
本研究的目的是评估接受胸廓出口减压术的胸廓出口综合征患者的症状改善情况。在我们科室，我们更倾向于采用锁骨上入路，若存在纤维束带或颈肋，则进行前斜角肌切除术并切除之。手术细节通过手术记录和病例回顾获得。在6年期间，31例患者（37条肢体）接受了胸廓出口减压术。在这37条受累肢体中，手术指征为24例患者（65%）同时存在神经和血管症状，24例（65%）有神经症状，4例（11%）仅有血管症状。所有患者均在门诊或通过个人联系评估术后结果。从本研究结果我们得出结论，对于大多数胸廓出口综合征患者，锁骨上斜角肌切除术、颈肋切除术并选择性切除第一肋是一种安全有效的手术方法。
