Surgical Management of Thoracic Outlet Obstruction: Trans-Axillary Route

Objective: This study is mainly intended to review the results of surgical management in thoracic outlet syndrome (TOS) with clinical symptoms Method: A retrospective study was conducted in patients with TOS who were treated surgically through axillary route in Sankers hospital and DM wims during a period of 2011 to 2018 by the first author. All cases were having neurological symptoms of lower brachial plexus and were treated with first rib resection and scalenotomy (FRRS) and cervical rib resection in cases with cervical rib. Cases selected for operative procedure were subjected to nerve conduction velocity (NCV) studies and clinically assessed pre and post operatively. All cases were given 3-6 months physiotherapy prior to taking for surgical management. Result: During a period of 7 years 62 cases were performed and 25 cases were subjected to cervical rib resection 2 cases were having bilateral cervical rib and were treated surgically in different settings. The preferred surgical approach was through axillary route. All cases presented with pain parasthesia and difficulty in doing manual work and without vascular complications. Conclusion: FRRS and cervical rib resection if any can result in relief of symptoms in 96.8 % of cases.