Mackinnon S E, Patterson G A
Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Semin Thorac Cardiovasc Surg. 1996 Apr;8(2):208-13.
A supraclavicular approach will facilitate brachial plexus decompression and first rib resection. It allows the surgeon a complete visualization of all the neurovascular elements and removal of the first rib. In particular, under direct vision, the most posterior aspects of the first rib can be easily visualized and removed. During this dissection, care is taken to preserve the supraclavicular nerves. The technique of opening the pleura to allow drainage into the pleural cavity rather than around the brachial plexus will decrease postoperative scarring around the neural elements. Similarly, gentle but early postoperative movement of the head, neck, and upper extremity is encouraged in order to minimize scar formation around the brachial plexus.
锁骨上入路有助于臂丛神经减压和第一肋切除。它能让外科医生全面观察所有神经血管结构并切除第一肋。特别是在直视下，第一肋的最后方部分能够轻易被观察到并切除。在这个解剖过程中，要注意保护锁骨上神经。打开胸膜使其引流至胸腔而非臂丛神经周围的技术，将减少神经结构周围的术后瘢痕形成。同样，鼓励术后早期轻柔地活动头部、颈部和上肢，以尽量减少臂丛神经周围的瘢痕形成。
