Thoracic outlet syndrome after the Nuss procedure for pectus excavatum: Is it a rare complication?

Nagasao, Tomohisa; Morotomi, Tadaaki; Kuriyama, Masafumi; Kogure, Tetsukuni; Kudo, Hirro; Hamamoto, Yusuke; Tamai, Masamitsu

doi:10.1016/j.bjps.2017.05.043

Cited by 12 publications

(5 citation statements)

References 25 publications

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“…TOS is also a rare encountered complication of Nuss procedure. 8 9 10 11 The morphological change of the thoracic wall after Nuss procedure can affect regional nerves and vessels. 11 The elevation of the upper chest conditioned by the sternal lifting after bar placement may narrow the space between the first rib and the clavicle, eventually causing compression of the neurovascular.…”

Section: Discussionmentioning

confidence: 99%

“…8 9 10 11 The morphological change of the thoracic wall after Nuss procedure can affect regional nerves and vessels. 11 The elevation of the upper chest conditioned by the sternal lifting after bar placement may narrow the space between the first rib and the clavicle, eventually causing compression of the neurovascular. Kim et al confirmed this structural changes in their study, by measuring costoclavicular spaces in PE patients and control groups.…”

Section: Discussionmentioning

confidence: 99%

“…Three sites of compression are possible: beneath the anterior scalene muscle, in the costoclavicular space, or beneath the pectoralis minor muscle. 11 13 Several causes of compression are known. Soft tissue and osseous alterations are the most frequent culprits attributed to TOS.…”

Section: Discussionmentioning

confidence: 99%

“…According to Nagasao et al, 11 female patients and those with severe forms of PE are at a higher risk of developing TOS after PE correction. In this work, it is also stated that a superior placement of the thoracic bars leads to a higher elevation of the sternum, augmenting the risk of neurovascular bundle's compression.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic Outlet Syndrome after Minimally Invasive Repair of Pectus Excavatum in a 15-Year-Old Boy: A Case Report

Fernandes

Soares‐Aquino

Monteiro

et al. 2022

European J Pediatr Surg Rep.

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Nuss procedure has become the treatment of choice in pectus excavatum mainly because of the excellent functional and cosmetic results. Despite the good results, several complications have been reported. The aim of this study is to describe a case of thoracic outlet syndrome (TOS) after Nuss procedure and review the management of such rare complication. A 15-year-old boy otherwise healthy was submitted to Nuss procedure, with no perioperative complications. Two-weeks later, the patient complained of right-hand paresthesia, progressive weakness of the right arm and coldness. After imaging and electromyography, TOS diagnosis was established. Removal of the bar was proposed but refused by the patient. Conservative management with rehabilitation exercising and nerve nourishing was initiated. At 7 months, the patient recovered arm and hand function. Abrupt structural changes of thoracic cavity with marked elevation of the upper chest induce nerve and vascular compression arousing a TOS and should be acknowledged as one potential complication of Nuss procedure. Conservative management can be an alternative treatment to bar removal, showing good results on functional recovery in early stages of compression.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Thoracic Outlet Syndrome after Minimally Invasive Repair of Pectus Excavatum in a 15-Year-Old Boy: A Case Report

Fernandes

Soares‐Aquino

Monteiro

et al. 2022

European J Pediatr Surg Rep.

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“…Morphological changes in the thoracic wall following the Nuss procedure can affect nerves and vessels neighboring the thoracic wall. Nagasao et al (21) demonstrated that a considerable proportion of adult patients developed thoracic outlet syndrome after the Nuss procedure for PE. Thoracic outlet syndrome can develop when nerves or vessels dominating the upper limbs are compressed beneath the anterior scalene muscles or minor pectoral muscles.…”

Section: Discussionmentioning

confidence: 99%

Changes in thoracic cavity dimensions of pectus excavatum patients following Nuss procedure

et al. 2018

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Complications and Hazards with Pectus Excavatum Surgeries: Secondary Surgical Procedures with Implants

Barthes

Hunt²,

Shah

et al. 2019

Pectus Excavatum and Poland Syndrome Surgery

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Thoracic outlet syndrome after the Nuss procedure for pectus excavatum: Is it a rare complication?

Cited by 12 publications

References 25 publications

Thoracic Outlet Syndrome after Minimally Invasive Repair of Pectus Excavatum in a 15-Year-Old Boy: A Case Report

Thoracic Outlet Syndrome after Minimally Invasive Repair of Pectus Excavatum in a 15-Year-Old Boy: A Case Report

Changes in thoracic cavity dimensions of pectus excavatum patients following Nuss procedure

Complications and Hazards with Pectus Excavatum Surgeries: Secondary Surgical Procedures with Implants

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