Background: Thoracic outlet syndrome (TOS) is a complex entityresulting in neurogenic or vascular manifestations. A wide array of procedureshas evolved, each with its own benefits and drawbacks. The authors hypothesizedthat treatment of TOS with first rib resection (FRR) may lead to increasedcomplication rates. Methods: A retrospective case control study wasperformed on the basis of the National Surgical Quality Improvement Programdatabase from 2005 to 2014. All cases involving the operative treatment of TOSwere extracted. Primary outcomes included surgical and medical complications.Analyses were primarily stratified by FRR and secondarily by other proceduretypes. Results: A total of 1853 patients met inclusion criteria.The most common procedures were FRR (64.0%), anterior scalenectomy with cervicalrib resection (32.9%), brachial plexus decompression (27.2%), and anteriorscalenectomy without cervical rib resection (AS, 8.9%). Factors associated withincreased medical complications included American Society of Anesthesiologists(ASA) classification of 3 or greater and increased operative time. The presenceor absence of FRR did not influence complication rates.Conclusions: FRR is not associated with an increased risk ofmedical or surgical complications. Medical complications are associated withincreased ASA scores and longer operative time.
展开▼
