Brown S C, Charlesworth D
University Department of Surgery, University Hospital of South Manchester, West Didsbury, UK.
Br J Surg. 1988 May;75(5):431-3. doi: 10.1002/bjs.1800750512.
Excision of a cervical rib in patients with the thoracic outlet syndrome has been the subject of debate. One surgeon's experience of 23 cervical rib excisions is presented. Ten operations produced a complete cure, eleven improvement, and two no change in the patient's condition. Of 15 cases with neurological symptoms alone, 9 were cured, 5 improved and 1 was not helped; in contrast, of 8 patients with vascular symptoms, 1 was cured, 6 were improved and 1 was not helped. We conclude that cervical rib resection is the correct treatment for patients whose symptoms are predominantly neurological. Rib resection alone may not be sufficient in patients with vascular symptoms. The management of a cervical rib with vascular involvement is discussed.
胸廓出口综合征患者的颈肋切除术一直是争论的焦点。本文介绍了一位外科医生进行23例颈肋切除术的经验。10例手术使患者完全治愈，11例有所改善，2例病情未变。仅出现神经症状的15例患者中，9例治愈，5例改善，1例无效；相比之下，8例有血管症状的患者中，1例治愈，6例改善，1例无效。我们得出结论，对于以神经症状为主的患者，颈肋切除术是正确的治疗方法。对于有血管症状的患者，仅切除肋骨可能并不足够。本文还讨论了合并血管受累的颈肋的处理方法。
