Thoracic outlet syndrome: a surgical approach by videothoracoscopy

Abstract

The thoracic outlet syndrome results in the neurovascular structures compression in the designated region of the space between the collarbone and the first rib (thoracic outlet). May be divided between classic neurogenic or true, atypical neurogenic or vascular, and each one of them has a different compression mechanism and can be represented by a bony anomalous structure, costoclavicular reduction space or by the arm's hyper abduction. The diagnosis is complex, and complementary exams such as: radiography, MRI, angiography helps in the viewing of the involved structure. The treatment may be done in two ways: conservative (exercises for posture correction and muscular strengthening, combined with symptomatic treatment) and surgical, (the base is a resection of the first rib and may be associated with scalenectomy or cervical rib resection). The surgical technique by videothoracoscopic video-assisted surgery is poorly reported, therefore, technically attractive and related to less invasiveness and greater safety. In this article, it will be revised the facts about the pathology and its therapeutic approach.