ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Surgical approach to thoracic outlet compression syndrome
Cemal KAHRAMAN, Yiğit AKÇALI, Fahri OĞUZKAYA, Kutay TAŞDEMİR, Mehmed BİLGİN, Atalay ŞAHİN
Erciyes Üniversitesi Tıp Fakültesi Göğüs ve Kalp-Damar Cerrahisi Anabilim Dalı, Kayseri
Thoracic outlet syndrome (TOS) is a complex of the symptoms which are related with neurovascular compression in the thoracic outlet area. The manage ment of the TOS are achieved by conservative or non- operative methods such as physiotherapy and/or surgical interventions. We reviwed the patients who were managed surgically because of TOS. in our department, we managed surgically twenty-eight patients with TOS in the last ten years. The causes of the compression were the soft tissue structures in the cases (37.7 %), and the osseous structures in 18 cases (64.3 %), The compression of the brachial plexus was noted in the rate of 85.7 percent. The vascular complications of the TOS were arterial thrombosis or thromboembolism, venous thrombosis, and Ray- naud’ s phenomenon (14.3 %). Paresthesia (100 %) and pain (67.8 %) were the clinic manifestations which were noted frequently. The supraclavicular approach was used in the involvement of the upper brachial plexus C5-7 (57 %), and the transaxillary one was used in the lesions of lower brachial plexus (i.e, C8-11) or in the compression of the osseous structures (42.9 %). Postoperative complications were incisional hematoma (3.5 %), transient power loss (3.5 %) and causalgia (3.5 %). The postoperative results were good in 32.1 %, fair in 57.2 % and poor 10.7 %, Recurrent TOS developed in two cases (7 %), and was noted pseudorecurrence in one case. The management of the TOS is surgical one in the selected cases, and improvement is over the rate of 80 %.
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