Peek Jesse, Vos Cornelis G, Ünlü Çağdas, Schreve Michiel A, van de Mortel Rob H W, de Vries Jean-Paul P M
Department of Vascular Surgery, St Antonius Hospital, 3435CM Nieuwegein, The Netherlands.
Department of Vascular Surgery, Medical Center Alkmaar, 1815JD Alkmaar, The Netherlands.
Diagnostics (Basel). 2018 Jan 12;8(1):7. doi: 10.3390/diagnostics8010007.
First rib resection for thoracic outlet syndrome (TOS) is clinically successful and safe in most patients. However, long-term functional outcomes are still insufficiently known. Long-term functional outcome was assessed using a validated questionnaire. A multicenter retrospective cohort study including all patients who underwent operations for TOS from January 2005 until December 2016. Clinical records were reviewed and the long-term functional outcome was assessed by the 11-item version of the Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Sixty-two cases of TOS in 56 patients were analyzed: 36 neurogenic TOS, 13 arterial TOS, 7 venous TOS, and 6 combined TOS. There was no 30-day mortality. One reoperation because of bleeding was performed and five patients developed a pneumothorax. Survey response was 73% ( = 41) with a follow-up ranging from 1 to 11 years. Complete relief of symptoms was reported postoperatively in 27 patients (54%), symptoms improved in 90%, and the mean QuickDASH score was 22 (range, 0-86). Long-term functional outcome of surgical treatment of TOS was satisfactory, and surgery was beneficial in 90% of patients, with a low risk of severe morbidity. However, the mean QuickDASH scores remain higher compared with the general population, suggesting some sustained functional impairment despite clinical improvement of symptoms.
对于胸廓出口综合征(TOS)患者,首次肋骨切除术在大多数情况下临床效果良好且安全。然而,其长期功能预后仍知之甚少。我们使用经过验证的问卷评估长期功能预后。这是一项多中心回顾性队列研究,纳入了2005年1月至2016年12月期间所有接受TOS手术的患者。查阅临床记录,并通过手臂、肩部和手部功能障碍11项问卷(QuickDASH)评估长期功能预后。分析了56例患者的62例TOS病例:36例神经源性TOS,13例动脉性TOS,7例静脉性TOS,6例混合型TOS。无30天内死亡病例。因出血进行了1次再次手术,5例患者发生气胸。调查回复率为73%(n = 41),随访时间为1至11年。术后27例患者(54%)报告症状完全缓解,90%的患者症状改善,QuickDASH平均评分为22分(范围0 - 86)。TOS手术治疗的长期功能预后令人满意,90%的患者手术有益,严重并发症风险低。然而,与普通人群相比,QuickDASH平均评分仍较高,提示尽管症状有临床改善,但仍存在一些持续性功能损害。