SURGICAL DECOMPRESSION OF THORACIC OUTLET SYNDROME - IS IT A WORTHWHILE PROCEDURE

During a 20-year period from 1974 to 1994, 37 thoracic outlet decompre ssions were performed. There were 28 females and six males (ratio 5 : 1). The median age was 37 years (range 15-64). Symptoms were predomina tely neurological in 29 limbs (78%), arterial in five limbs (14%) and venous in three limbs (8%). Limb pain and paraesthesia were the most c ommon symptoms. Surgical decompression was performed via a supraclavic ular approach in 24 limbs (65%) and a transaxillary approach in 13 lim bs (35%). A cervical rib was excised in 21 limbs (57%), a first rib in 10 limbs (27%), a cervical and first rib in one limb (3%) and a cervi cal band in five limbs (13%). Arterial reconstruction was only require d in three Limbs (8%). There were a total of four complications (11%). The outcome of surgical decompression was assessed by using a questio nnaire completed by the patient. Overall 27 patients (87%) felt that t he operation was worthwhile. These results show that surgical decompre ssion for thoracic outlet syndrome is a worthwhile procedure and is as sociated with relatively few complications.