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首页> 外文期刊>Vascular and endovascular surgery >Long-term functional results for the surgical management of neurogenic thoracic outlet syndrome.
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Long-term functional results for the surgical management of neurogenic thoracic outlet syndrome.

机译：神经源性胸廓出口综合征的外科治疗的长期功能结果。

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OBJECTIVE: To document long-term functional outcomes in patients treated for neurogenic thoracic outlet syndrome (NTOS). METHODS: Records of all patients undergoing treatment for NTOS at our center were reviewed. Patient demographics and co-morbidities were recorded. End-points included symptomatic relief, peri-operative adjunctive procedures, functional outcome and employment continuity. RESULTS: From 1988-2008, 26 patients were operated upon for NTOS. Hallmarks of the diagnosis in operated patients included symptom duration less than 1 year and a positive Roos test. Patients receiving disability and those with cervical spine pathology or carpal tunnel syndrome were not considered for surgery. Mean patient age was 39.2 years (range 14-60 years) with a mean follow-up of 104.4 months. Eleven patients (42.3%) engaged in pre-operative physical therapy programs. 7 of 9 patients (26.9%) received adjunctive peri-procedural scalene block with temporary symptom relief. All patients underwent thoracic outlet decompression by either 1st rib resection [18 total: 8 (44%) transaxillary and 10 (66%) supraclavicular)], cervical rib resection [6 (26.1%)] and/or scalenectomy [12 (46.2%)]. Of the 22 patients available for follow-up, six patients (27.3%) have required continued post-operative narcotic analgesics. Sixteen patients (72.7%) returned to work and reported being at an equivalent or better functional outcome than their pre-operative status. CONCLUSIONS: Durable long-term functional outcomes can be achieved predicated on a highly selective approach to the surgical management of patients with NTOS. A majority of operated patients will not require adjunctive procedures or chronic narcotic utilization. Patients who undergo surgery can expect to return to work with little or no functional impairment.
机译：目的：记录治疗神经源性胸廓出口综合征（NTOS）的患者的长期功能结局。方法：回顾了我中心接受NTOS治疗的所有患者的记录。记录患者的人口统计学和合并症。终点包括症状缓解，围手术期辅助程序，功能结果和就业连续性。结果：从1988- 2008年，有26例患者接受了NTOS手术。手术患者的诊断标志包括症状持续时间少于1年和Roos测试阳性。不考虑患有残疾的患者以及患有颈椎病或腕管综合症的患者进行手术。患者平均年龄为39.2岁（范围14-60岁），平均随访时间为104.4个月。十一名患者（42.3％）参加了术前物理治疗计划。 9例患者中有7例（26.9％）接受了辅助性围手术期斜角肌阻滞并暂时缓解症状。所有患者均通过第1肋骨切除术[18例：经腋窝8例（44％）和锁骨上肌10例（66％）]进行胸廓出口减压，[1（66.1％）]颈椎肋骨切除术[/ 12]（46.2％） ）]。在22位可随访的患者中，有6位患者（27.3％）需要继续术后麻醉性镇痛。 16名患者（72.7％）重返工作岗位，并报告其功能结局与其术前状态相当或更好。结论：采用高度选择性的NTOS患者手术治疗方法可以实现长期的长期功能结局。大多数手术患者将不需要辅助手术或长期使用麻醉剂。接受手术的患者可以恢复正常工作，很少或没有功能障碍。

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