Long-term results of surgical decompression of thoracic outlet compression syndrome.
Long-term results of surgical decompression of thoracic outlet compression syndrome.
复制标题
胸廓出口受压综合征手术减压的长期结果。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
Lamerton Aj
中科院分区：
文献类型：
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作者：
CA Maxwell;B. Noorpuri;Haque Sa;Baker Dm;Lamerton Aj
背景
胸廓出口受压综合征的特征是与神经血管束受压有关的各种症状。虽然没有一种测试是针对这种综合征的，但在高达99%的病例中，手术后症状可能会得到缓解。
患者和方法
本文回顾了经锁骨上入路的118例患者的手术笔记，共126例。症状、术前检查和并发症都被记录在案。同时记录6周、6个月、12个月和24个月的随访结果。此外，还通过电话联系了61名患者，以评估目前的症状水平。
结果
症状主要是运动、感觉或血管运动，在手术前平均存在19.6个月。并发症很少见，但包括气胸需要胸腔引流(n=1)和锁骨下麻醉(n=13)。平均住院天数为2.1天。在6周的随访中，86.5%的患者报告症状有所改善或完全消失。61名患者是可接触的，平均在减压后55个月。其中44例(72.1%)症状改善或无症状。
结论
采用锁骨上入路行第一肋骨切除减压术治疗胸廓出口压迫综合征，远期效果良好，并发症少。
BACKGROUND
Thoracic outlet compression syndrome is characterised by a variety of symptoms relating to compression of the neurovascular bundle. Though no one test is specific for the syndrome, relief of symptoms may be obtained following surgery in up to 99% of cases.
PATIENTS AND METHODS
The notes of 118 patients operated on in 126 operations by a single surgeon using a supraclavicular approach were reviewed. Symptoms, pre-operative investigations, and complications were all documented. Outcome at 6 weeks, 6, 12 and 24 months follow-up was also recorded. In addition, 61 patients were contacted by telephone, in order to assess current level of symptoms.
RESULTS
Symptoms were predominantly motor, sensory or vasomotor, and were present for a mean of 19.6 months prior to surgery. Complications were rare, but included a pneumothorax requiring a chest drain (n = 1) and infraclavicular anaesthesia (n = 13). The mean duration of hospital stay was 2.1 days. At 6 weeks follow up, 86.5% of patients reported either an improvement, or complete resolution of their symptoms. Sixty-one patients were contactable, a mean of 55 months following decompression. Of these, 44 (72.1%) were either improved or asymptomatic.
CONCLUSION
Decompression for thoracic outlet compression syndrome through a supraclavicular approach encompassing first rib resection leads to good long-term results with few complications.