Geven Leontien I, Smit Andries J, Ebels Tjark
Department of Cardiothoracic Surgery, University Medical Center Groningen, The Netherlands.
Eur J Cardiothorac Surg. 2006 Aug;30(2):232-6. doi: 10.1016/j.ejcts.2006.04.018. Epub 2006 Jul 7.
To assess the role of the relative length of the posterior rib stump in outcome after transaxillary first rib resection for thoracic outlet syndrome.
All patients with a transaxillary first rib resection between January 1990 and February 2004 were selected. Relative rib stump length was calculated by dividing the length of the posterior rib stump by the height of the 10th thoracic vertebra. Measurements were made on postoperative X-rays. Outcome was defined as excellent, good, fair, or poor.
Surgical outcome was excellent in 11 procedures (28.2%), good in 12 procedures (30.8%), fair in 9 (23.1%), and poor in 7 procedures (17.9%). Correlation of the outcome with the relative rib stump length gives a coefficient of .374 (P=.02). After exclusions of 3 patients with other medical conditions explanatory for remaining pain in the operated limb, the correlation coefficient was .614 (P<.01).
The relative length of the posterior rib stump is correlated with the outcome after transaxillary first rib resection in patients with thoracic outlet syndrome. First rib resection in patients with proven vascular compression should be as close as possible to the articulation with the transverse process, without injuring the brachial plexus.
评估在胸廓出口综合征患者经腋路第一肋切除术后，后肋残端相对长度对手术结果的作用。
选取1990年1月至2004年2月间所有接受经腋路第一肋切除术的患者。后肋残端长度除以第10胸椎高度计算出后肋残端相对长度。测量值通过术后X线片得出。手术结果分为优、良、可、差。
11例手术（28.2%）结果为优，12例（30.8%）为良，9例（23.1%）为可，7例（17.9%）为差。手术结果与后肋残端相对长度的相关性系数为0.374（P = 0.02）。排除3例因其他疾病导致患侧肢体持续疼痛的患者后，相关性系数为0.614（P < 0.01）。
胸廓出口综合征患者经腋路第一肋切除术后，后肋残端相对长度与手术结果相关。对于已证实存在血管受压的患者，第一肋切除应尽可能靠近与横突的关节处，同时避免损伤臂丛神经。
