Gruss J D, Bartels D, Vargas H, Ohta T, Tsafandakis E, Schlechtweg B, Haidar A
J Cardiovasc Surg (Torino). 1982 May-Jun;23(3):221-4.
Nowadays all compression syndromes at the upper chest like the costoclavicular syndrome, the scalenus syndrome, the hyperabduction syndrome and the Page-von Schroetter syndrome are included under the term of thoracic-outlet-syndrome. Apart from a constitutional disposition (cervical rib, anomalies of the tendons, etc.), it needs special factors like professional activities, sports, trauma, etc. to develop a T.O.S. syndrome. The symptoms range from prickling paresthesia, early fatigue, pains in shoulder and neck, claudication like pains and strong tendency towards swelling and rest pain or peripheral gangrene. Among 3126 vascular-surgical operations 128 transaxillary rib resections were performed during the time from June 1st, 1975 until March 31st, 1980. On 105 occasions rib resection was combined with the thoracic sympathectomy. In only 4 cases the resection of a cervical rib was sufficient to obtain decompression; in 15 cases the first rib had to be resected with a cervical rib. In 3 cases direct reconstructions of the artery and subclavian vein was performed by way of transaxillary approach. Postoperatively, 56% of the patients remained completely asymptomatic, 32% were decidedly improved and 12% unchanged.
如今，所有上胸部的压迫综合征，如肋锁综合征、斜角肌综合征、过度外展综合征和佩奇 - 冯·施勒特综合征，都被纳入胸廓出口综合征这一术语范畴。除了先天性因素（颈肋、肌腱异常等）外，胸廓出口综合征的发生还需要诸如职业活动、运动、创伤等特殊因素。其症状包括刺痛、感觉异常、早期疲劳、肩颈部疼痛、间歇性跛行样疼痛以及强烈的肿胀倾向和静息痛或周围坏疽。在1975年6月1日至1980年3月31日期间进行的3126例血管外科手术中，共进行了128例经腋路肋骨切除术。其中105例肋骨切除术与胸交感神经切除术联合进行。仅4例切除颈肋就足以实现减压；15例中必须同时切除第一肋和颈肋。3例通过经腋路对动脉和锁骨下静脉进行了直接重建。术后，56%的患者完全无症状，32%明显改善，12%无变化。
