Outcome of Transaxillary Rib Resection for Thoracic Outlet Syndrome — a 10 Year Experience

Abstract

Background: This study assessed the outcome of transaxillary first and/or cervical rib resection in a unit, which has a policy of combined assessment by a neurologist and vascular surgeon. Methods: 61 patients underwent 83 transaxillary rib resections for thoracic outlet syndrome. A retrospective casenote review of these patients was undertaken. All patients completed a telephone questionnaire regarding long-term outcome. Results: Post-operative outpatient assessment at a median of 6 months recorded 91.5% improved, of whom 61.5% were symptom-free. 61% were available for the telephone questionnaire at a median follow-up of 4 yr. 74% reported an improvement, with complete resolution in 58%. Six described temporary improvement following surgery. Conclusion: Transaxillary rib resection is a safe and effective procedure, allowing almost two thirds of patients a return to normal activity. Combined assessment by vascular and neurological teams may help in patient selection for surgery, as well as the accurate long-term assessment of outcome.