Kelly T R
Ann Surg. 1979 Nov;190(5):657-62. doi: 10.1097/00000658-197911000-00017.
This current concept of treatment of the Thoracic Outlet Syndrome based on a personal experience with 304 patients, resulted in complete (85%) or partial (7%) relief of symptoms in 92% of operated patients. The diagnosis centers upon a thorough history and the exclusion of other causes of arm and shoulder pain utilizing a strict flow pattern of differential diagnosis. Angiography and electromyography are of limited value and are only performed in selected cases. Operation should be reserved for the thoroughly evaluated patient who continues to have pain despite adequate conservative therapy. Transaxillary removal of the first rib, fibromuscular bands and cervical rib, when present, is the operation of choice.
基于对304例患者的个人经验，目前这种胸廓出口综合征的治疗理念使92%的手术患者症状完全缓解（85%）或部分缓解（7%）。诊断基于详尽的病史，并采用严格的鉴别诊断流程排除手臂和肩部疼痛的其他原因。血管造影和肌电图的价值有限，仅在特定病例中进行。手术应仅适用于经过全面评估、尽管接受了充分的保守治疗仍持续疼痛的患者。经腋路切除第一肋、纤维肌束和颈肋（如有）是首选手术方式。
