Experience of supraclavicular exploration and decompression for treatment of thoracic outlet syndrome

The purpose of this study was to assess the symptomatic outcome of patients with thoracic outlet syndrome who underwent decompression of the thoracic outlet. In our unit we prefer the supraclavicular approach, performing ante rior scalenectomy with excision of fibrous bands or cervical ribs if presen t. Operative details were gained by theater logbook and case note review. O ver a 6-year period, 31 patients (37 limbs) underwent thoracic outlet decom pression. Of the 37 affected limbs, the indications for surgery were a comb ination of both neurological and vascular symptoms in 24 patients (65%), ne urological symptoms in 24 (65%), and 4 patients (11%) had vascular symptoms alone. All patients were assessed for postoperative outcome either at outp atient clinics or by personal contact. From the results of this study we co ncluded that supraclavicular scalenectomy and cervical rib excision with se lective first rib excision is a safe and effective procedure for most patie nts with thoracic outlet syndrome.