Murphy T O, Piper C A, Kanar E A, McAlexander R A
Am J Surg. 1980 May;139(5):634-6. doi: 10.1016/0002-9610(80)90351-7.
As discussed by Urschel [13], 50 to 70 percent of patients with symptoms of thoracic outlet syndrome may be treated conservatively by nonsurgical methods. Patients who still have symptoms after years of such therapy are referred to us for surgical treatment. Failure to obtain symptomatic relief after scalenotomy alone [8] caused us to abandon this treatment. The advantages of the subclavicular approach to first rib resection are as follows: (1) The operation is easy and fast. (2) There is good visibility in the operative field. (3) The neurovascular bundle to the arm lies cephalad and out of harm's way. (4) The complication (infection) rate is very low. (5) The operation allows adequate resection of the first rib. (6) The operation allows the addition of upper extremity sympathectomy. The disadvantage is the position of the scar in a young woman, although lateral placement of the scar does not seem to cause much emotional trauma.
正如厄舍尔[13]所讨论的，50%至70%有胸廓出口综合征症状的患者可以通过非手术方法进行保守治疗。经过数年这种治疗仍有症状的患者会被转诊至我们这里接受手术治疗。单独进行斜角肌切断术后未能获得症状缓解[8]，促使我们放弃了这种治疗方法。锁骨下入路切除第一肋的优点如下：（1）手术简便快捷。（2）手术视野清晰。（3）手臂的神经血管束位于头侧，不会受到损伤。（4）并发症（感染）发生率非常低。（5）该手术能够充分切除第一肋。（6）该手术可以加做上肢交感神经切除术。缺点是年轻女性患者的瘢痕位置，不过瘢痕外侧放置似乎不会造成太大的心理创伤。
