Long-term results of surgical decompression of thoracic outlet compressionsyndrome

Background: Thoracic outlet compression syndrome is characterised by a vari ety of symptoms relating to compression of the neurovascular bundle. Though no one test is specific for the syndrome, relief of symptoms may be obtain ed 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 investigati ons, and complications were all documented. Outcome at 6 weeks, 6, 12 and 2 4 months follow-up was also recorded. In addition,61 patients were contacte d by telephone, in order to assess current level of symptoms. Results: Symp toms were predominantly motor, sensory or vasomotor, and were present for a mean of 19.6 months prior to surgery. Complications were rare, but include d a pneumothorax requiring a chest drain (n=1) and infraclavicular anaesthe sia (n=13), The mean duration of hospital stay was 2.1 days. At 6 weeks fol low up, 86.5% of patients reported either an improvement, or complete resol ution of their symptoms. Sixty-one patients were contactable, a mean of 55 months following decompression. Of these, 44 (72.1%) were either improved o r asymptomatic. Conclusion: Decompression for thoracic outlet compression s yndrome through a supraclavicular approach encompassing first rib resection leads to good long-term results with few complications.