DOI: https://doi.org/10.22141/1608-1706.3.17.2016.75791

Features of Surgical Treatment of Patients with Thoracic Outlet Syndrome

V.I. Tsymbaliuk, I.B. Tretiak, Jiang Hao

Abstract


Introduction. Thoracic outlet syndrome — a collective term including a group of neurovascular syndromes. According to the world statistics, the prevalence of thoracic outlet syndrome among population is 0.3–2 %. Selecting the extent of surgical intervention, optimal time for surgical treatment and relapse prevention remain relevant today. The aim of the study was to improve the outcomes of surgical treatment in patients with thoracic outlet syndrome by differentiated use of various surgical interventions. Materials and methods. There were evaluated the results of surgical treatment of 71 patients with thoracic outlet syndrome by anterior supraclavicular approach. Standard methods of surgical treatment including neurolysis of the brachial plexus structures, angiolysis of subclavian vessels, scalenotomy and resection of the cervical rib (if necessary) were used in 35 patients; alongside with standard surgery, resection of the firs rib was performed in 17 patients, and during standard surgery, electrical stimulation system Nei Si-3M (WEL SPE, Ukraine) was additionally implanted in 19 patients for chronic electrical stimulation of the brachial plexus in the postoperative period. Results. The positive effect resulted from chronic electrical stimulation of the brachial plexus, which was evidenced by improved trophic function and neurological status, was observed in 94.7 % of patients. Conclusions. Chronic electrical stimulation of the structures of the brachial plexus can significantly shorten the period of neurological recovery and ensure the stable regression of pain syndrome in the postoperative period.


Keywords


thoracic outlet syndrome; scalenus anticus syndrome; cervical rib syndrome; resection of the first rib; chronic electrical stimulation

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