scholarly journals A Novel Approach to First-Rib Resection in Neurogenic Thoracic Outlet Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Yueying Li ◽  
Yanxi Liu ◽  
Zhan Zhang ◽  
Xuehai Gao ◽  
Shusen Cui
Keyword(s):  
Postoperative Complications ◽  
Patient Group ◽  
Thoracic Outlet Syndrome ◽  
Operative Time ◽  
Conventional Group ◽  
Rib Resection ◽  
Surgery Group ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
First Rib Resection

Objectives: The treatment for neurogenic thoracic outlet syndrome (NTOS) conventionally involves first-rib resection (FRR) surgery, which is quite challenging to perform, especially for novices, and is often associated with postoperative complications. Herein, we report a new segmental resection approach through piezo surgery that involves using a bone cutter, which can uniquely provide a soft tissue protective effect.Methods: This retrospective study involved the examination of 26 NTOS patients who underwent piezo surgery and another group of 30 patients who underwent FRR using the conventional technique. In the patient group that underwent piezo surgery, the rib was first resected into two pieces using a piezoelectric device and subsequently removed. In the patient group that underwent conventional surgery, the first rib was removed as one piece using a rib cutter and rongeurs.Results: The piezo surgery group had significantly shorter operative time (96.85 ± 14.66 vs. 143.33 ± 25.64 min, P < 0.001) and FRR duration (8.73 ± 2.11 vs. 22.23 ± 6.27 min, P < 0.001) than the conventional group. The posterior stump length of the residual rib was shorter in the piezo surgery group than in the conventional group (0.54 ± 0.19 vs. 0.65 ± 0.15 cm, P < 0.05). There were no significant differences in postoperative complications and scores of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Cervical Brachial Symptom Questionnaire (CBSQ), and the visual analog scale (VAS). Even the TOS index (NTOS Index = [DASH + (0.83 × CBSQ) + (10 × VAS)]/3) and patient self-assessments of both the groups showed no significant differences. Univariate analyses indicated that the type of treatment affected operative time.Conclusion: Our results suggest that piezo surgery is safe, effective, and simple for segmental FRR in NTOS patients. Piezo surgery provides a more thorough FRR without damaging adjacent soft tissues in a relatively short duration and achieves similar functional recovery as conventional techniques. Therefore, piezo surgery can be a promising alternative for FRR during the surgical treatment of NTOS.

scholarly journals Morbidity of First Rib Resection in the Surgical Repair of Thoracic Outlet Syndrome

Hand ◽  
2018 ◽  
Vol 14 (5) ◽  
pp. 636-640 ◽  
Author(s):  
Kevin T. Jubbal ◽  
Dmitry Zavlin ◽  
Joshua D. Harris ◽  
Shari R. Liberman ◽  
Anthony Echo
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Operative Time ◽  
Medical Complications ◽  
Complication Rates ◽  
Improvement Program ◽  
Cervical Rib ◽  
Rib Resection ◽  
First Rib ◽  
Increased Risk ◽  
First Rib Resection

Background: Thoracic outlet syndrome (TOS) is a complex entity resulting in neurogenic or vascular manifestations. A wide array of procedures has evolved, each with its own benefits and drawbacks. The authors hypothesized that treatment of TOS with first rib resection (FRR) may lead to increased complication rates. Methods: A retrospective case control study was performed on the basis of the National Surgical Quality Improvement Program database from 2005 to 2014. All cases involving the operative treatment of TOS were extracted. Primary outcomes included surgical and medical complications. Analyses were primarily stratified by FRR and secondarily by other procedure types. Results: A total of 1853 patients met inclusion criteria. The most common procedures were FRR (64.0%), anterior scalenectomy with cervical rib resection (32.9%), brachial plexus decompression (27.2%), and anterior scalenectomy without cervical rib resection (AS, 8.9%). Factors associated with increased medical complications included American Society of Anesthesiologists (ASA) classification of 3 or greater and increased operative time. The presence or absence of FRR did not influence complication rates. Conclusions: FRR is not associated with an increased risk of medical or surgical complications. Medical complications are associated with increased ASA scores and longer operative time.

scholarly journals Quality-of-life scores in neurogenic thoracic outlet syndrome patients undergoing first rib resection and scalenectomy

2013 ◽  
Vol 57 (2) ◽  
pp. 436-443 ◽  
Author(s):  
Danielle H. Rochlin ◽  
Marta M. Gilson ◽  
Kendall C. Likes ◽  
Emma Graf ◽  
Nancy Ford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thoracic Outlet Syndrome ◽  
Rib Resection ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
First Rib Resection

scholarly journals PC144 Athletes Have Better Outcomes Than Nonathletes After First Rib Resection and Scalenectomy for Neurogenic Thoracic Outlet Syndrome

2017 ◽  
Vol 65 (6) ◽  
pp. 177S-178S
Author(s):  
William P. Shutze ◽  
Ryan Shutze ◽  
Kimberly Tran ◽  
Allen Dao ◽  
Bradford Richardson ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Rib Resection ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
First Rib Resection

scholarly journals A modified supraclavicular approach to scalenotomy without first rib resection for the treatment of neurogenic thoracic outlet syndrome

2021 ◽  
pp. 101243
Author(s):  
Parménides Guadarrama-Ortíz ◽  
Ingrid Montes de Oca-Vargas ◽  
André Garibay-Gracián ◽  
José Alberto Choreño-Parra ◽  
César Osvaldo Ruíz-Rivero ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Supraclavicular Approach ◽  
Rib Resection ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
First Rib Resection

SURGICAL TREATMENT OF NEUROGENIC THORACIC OUTLET SYNDROME SECONDARY TO THE CLAVICLE HAEMATOGENIC SUBACUTE OSTEOMYELITIS

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 161-165 ◽  
Author(s):  
Martins Kapickis ◽  
Amitabha Lahiri ◽  
Guntars Pupelis
Keyword(s):  
Surgical Treatment ◽  
Rare Case ◽  
Thoracic Outlet Syndrome ◽  
Rib Resection ◽  
Diagnosis And Management ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
Subacute Osteomyelitis ◽  
First Rib Resection

A rare case of neurogenic thoracic outlet syndrome secondary to subacute osteomyelitis (SOM) of clavicle is presented. It was treated successfully with scalenectomy combined with clavicle and first rib resection and reconstruction of the clavicle using vascularised seventh rib transfer. Various issues involved in the diagnosis and management of such a case are discussed.

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