Unit of Thoracic Surgery, S¸is¸li Hamidiye Etfal Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.oa.23-00110.
To present the clinical experience in video-assisted thoracic surgery (VATS) of first rib resection for patients with neurogenic thoracic outlet syndrome (NTOS).
The files of 13 patients (10 males, 3 females) having unilateral NTOS undergoing first rib resection via VATS were retrospectively investigated. The symptoms, operative times, durations of chest tube and hospital stay, complications, and postoperative courses were analyzed. All patients underwent VATS using a camera port and 3-5 cm utility incision.
There was no morbidity. The average operation time was 81 ± 11 min (range 65-100 min). Chest tubes were removed in the first or second postoperative day (mean 1.23 ± 0.43 days). The mean postoperative length of hospital stay was 2.1 ± 0.9 days (range 1-3 days). The average duration of follow-up was 19 ± 13 months (range 2-38 months). Ten patients completed a follow-up during 6 months. One patient (10%) had minor residual symptoms, and the remaining patients (90%) were fully asymptomatic.
The VATS approach in the resection of the first rib for thoracic outlet syndrome is a safe method. It should be performed with acceptable risks under experienced hands. The magnified view and optimal visualization from the scope are beneficial. Avoiding neurovascular bundle retraction may seem to decrease the postoperative pain.
介绍电视辅助胸腔镜手术（VATS）下第一肋骨切除术治疗神经源性胸廓出口综合征（NTOS）的临床经验。
回顾性分析了 13 例（男 10 例，女 3 例）单侧 NTOS 患者接受 VATS 下第一肋骨切除术的档案。分析了症状、手术时间、胸腔引流管和住院时间、并发症和术后过程。所有患者均采用摄像端口和 3-5cm 的实用切口行 VATS。
无发病率。平均手术时间为 81±11min（65-100min）。胸腔引流管于术后第 1 或第 2 天（平均 1.23±0.43 天）拔出。平均住院时间为 2.1±0.9 天（1-3 天）。平均随访时间为 19±13 个月（2-38 个月）。10 例患者在 6 个月内完成随访。1 例（10%）患者有轻微残留症状，其余患者（90%）完全无症状。
VATS 下胸廓出口综合征第一肋骨切除术是一种安全的方法。在有经验的医生手中，它可以以可接受的风险进行。镜头的放大视图和最佳可视化效果是有益的。避免神经血管束的回缩似乎可以减少术后疼痛。
