König R W, Kretschmer T, Börm W, Hübner F, Richter H-P, Antoniadis G
Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg.
Nervenarzt. 2005 Oct;76(10):1222, 1224-6, 1230. doi: 10.1007/s00115-005-1909-6.
Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial entrapment syndromes of the upper extremity. There are two different surgical approaches for its primary surgical treatment: supraclavicular decompression and transaxillary first rib resection. The aim of this study was to evaluate long-term results and surgical risks of the former.
This retrospective long-term study examines a series of 50 supraclavicular decompressions in 45 patients. Follow-up was for at least 24 months. All patients were reexamined regularly in nonstandardized fashion. Finally, each patient underwent a telephone interview with a standardized questionnaire.
There was a significant deterioration of primary results during follow-up. About 30.0% of cases worsened within 24 months after operation. In the long run, about 80.0% of cases showed improvement of symptoms (26.0% excellent, 36.0% good, 18.0% moderate). The complication rate was 4.0%.
Due to secondary deterioration of treatment during follow-up, only long-term studies are suited for the examination of neurogenic TOS. Results after supraclavicular decompression are satisfactory, and the complication rate is low.
神经源性胸廓出口综合征(TOS)是上肢最具争议的卡压综合征之一。其主要手术治疗有两种不同的手术方法:锁骨上减压术和经腋路第一肋切除术。本研究的目的是评估前者的长期效果和手术风险。
这项回顾性长期研究检查了45例患者的50例锁骨上减压术。随访至少24个月。所有患者均以非标准化方式定期复查。最后,对每位患者进行标准化问卷的电话访谈。
随访期间主要结果有显著恶化。约30.0%的病例在术后24个月内病情恶化。从长远来看,约80.0%的病例症状有所改善(26.0%为优,36.0%为良,18.0%为中)。并发症发生率为4.0%。
由于随访期间治疗出现继发性恶化,只有长期研究适合用于神经源性TOS的检查。锁骨上减压术后效果令人满意,并发症发生率低。