Surgical Approaches for Thoracic Outlet Syndrome: A Review of the Literature

Suzuki, Toshio; Kimura, Hiroo; Matsumura, Noboru; Iwamoto, Takuji

doi:10.1016/j.jhsg.2022.04.007

Cited by 12 publications

(5 citation statements)

References 19 publications

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“…However, different studies revealed different outcomes, since some of the studies reported similar outcomes in describing success rates of first rib resection alone and scalenectomy alone when anterior scalenotomy was substituted by anterior and middle scalenectomy. Further studies support scalenectomy with better outcomes and fewer complications compared to transaxillary first rib resection [11,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 91%

Recurrent Neurogenic Thoracic Outlet Syndrome (TOS): A Systematic Review of the Literature

Fahmi H. Kakamad,

Saywan K. Asaad,

Abdullah K. Ghafour

et al. 2023

Barw Medical Journal

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Introduction Thoracic outlet syndrome (TOS) is a set of symptoms that arise when neurovascular bundles are compressed in the course of passage through three spaces: the costoclavicular junction, the scalene triangle, and the pectoralis minor space. This study aims to review the literature regarding the proper management of recurrent TOS. Methods We conducted a systematic literature search using various databases up to December 20, 2022. The study included those articles in which the symptoms were regarded as recurrent if TOS-related symptoms like pain and/or discomfort recurred following an initial resolution of symptoms. Multiple data were gathered from the included studies, including the publication year, first author, country, sex, age, type of primary intervention, duration of physiotherapy, type of reoperation, compressing structures, and the outcome. Results The study included 14 articles. Two of the articles were case reports, 10 were case series, and the remaining were cohort studies. A total of 686 patients were included, of whom 506 (73.7%) were female. The ages ranged from 17 to 79 years, with varying means across the age groups. Nine out of 14 (64%) studies reported the first rib remnant as one of the causative factors in the recurrence of TOS. Excellent or good results were reported in 474 (69%) patients. Conclusion Recurrent TOS is a relatively common finding after primary treatment for neurogenic TOS. Management is similar to primary TOS, including conservative management and surgical intervention. The latter should not be delayed if conservative treatment fails.

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Section: Discussionmentioning

confidence: 91%

Recurrent Neurogenic Thoracic Outlet Syndrome (TOS): A Systematic Review of the Literature

Fahmi H. Kakamad,

Saywan K. Asaad,

Abdullah K. Ghafour

et al. 2023

Barw Medical Journal

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“…Manifestations of these conditions might include limb pallor, muscle weakness during exertion of the involved limb, paresthesias, muscle atrophy, pain, and venous thrombosis [ 3 ]. Presently, four primary surgical techniques address TOS: the transaxillary, supraclavicular, infraclavicular, and posterior approaches [ 4 ]. In the transaxillary approach, the incision is made in the axilla, between the pectoralis major and latissimus dorsi muscles.…”

Section: Discussionmentioning

confidence: 99%

Effective Postoperative Pain Management in Thoracic Outlet Syndrome Surgery: The Role of the Erector Spinae Plane Block

Barros,

Carvalho,

Pires

et al. 2023

Cureus

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Thoracic outlet syndrome (TOS) often necessitates surgical intervention to alleviate neurovascular bundle compression, which can result in severe postoperative pain. The myriad of surgical techniques available for TOS treatment, the intricate involvement of diverse sensory pathways, and the limited literature on effective analgesic methods for these specific cases underscore the need for successful approaches. This report introduces an efficacious multimodal analgesic strategy that incorporates the erector spinae plane (ESP) block to enhance postoperative pain management after a supraclavicular surgical approach. By combining this fascial block with a comprehensive rationale for its implementation, this case offers valuable insights into improving the postoperative care of TOS patients, ultimately aiming to enhance their comfort and recovery.

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“…The complication rate of VATS for TOS has been reported to be between 3-25%. Complications reported are due to wound infections, pneumothorax, and brachial plexus injuries, among others [5].…”

Section: Surgery For Treatment Of Tosmentioning

confidence: 99%

“…The mainstay of treatment is first rib resection and scalenectomy via a variety of approaches including transthoracic, transaxillary, supraclavicular, and infraclavicular [4]. One literature review cites a rate of 5% nerve injury in the transaxillary approach in addition to the supraclavicular approach, compared with a 3% rate in video-assisted thoracic surgery (VATS) [5].…”

Section: Introductionmentioning

confidence: 99%

Robotic First Rib Resection in Thoracic Outlet Syndrome: A Systematic Review of Current Literature

Reyes,

Alaparthi,

Roedl

et al. 2023

JCM

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Thoracic outlet syndrome (TOS) involves the compression of neurovascular structures in the thoracic outlet. TOS subtypes, including neurogenic (nTOS), venous (vTOS), and arterial (aTOS) are characterized by distinct clinical presentations and diagnostic considerations. This review explores the incidence, diagnostic challenges, and management of TOS with a focus on the innovative approach of Robotic First Rib Resection (R-FRR). Traditional management of TOS includes conservative measures and surgical interventions, with various open surgical approaches carrying risks of complications. R-FRR, a minimally invasive technique, offers advantages such as improved exposure, reduced injury risk to neurovascular structures, and shorter hospital stays. A comprehensive literature review was conducted to assess the outcomes of R-FRR for TOS. Data from 12 selected studies involving 397 patients with nTOS, vTOS, and aTOS were reviewed. The results indicate that R-FRR is associated with favorable intraoperative outcomes including minimal blood loss and low conversion rates to traditional approaches. Postoperatively, patients experienced decreased pain, improved function, and low complication rates. These findings support R-FRR as a safe and effective option for medically refractory TOS.

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Surgical Approaches for Thoracic Outlet Syndrome: A Review of the Literature

Cited by 12 publications

References 19 publications

Recurrent Neurogenic Thoracic Outlet Syndrome (TOS): A Systematic Review of the Literature

Recurrent Neurogenic Thoracic Outlet Syndrome (TOS): A Systematic Review of the Literature

Effective Postoperative Pain Management in Thoracic Outlet Syndrome Surgery: The Role of the Erector Spinae Plane Block

Robotic First Rib Resection in Thoracic Outlet Syndrome: A Systematic Review of Current Literature

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