Surgical Management of Neurogenic Thoracic Outlet Syndrome: A Systematic Review and Meta-analysis | ||||
| Zagazig University Medical Journal | ||||
| Article 42, Volume 31, Issue 1.1, January 2025, Page 370-378 PDF (1.35 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2024.327850.3636 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mohamed Mahmoud El-Hefnawy; Mohamad Othman Mohamed; Mohamed Sobh Elsaied Eid  ; Mohammed Hassan Abdellatif
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| Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt. | ||||
| Abstract | ||||
| Background: The thoracic outlet is the passage from the supraclavicular fossa to the axilla, connecting the first rib and the clavicle.Aim: To evaluate the clinical and radiological results of neurogenic thoracic outlet syndrome following surgical intervention. Patients and Methods: We conducted a search for possibly suitable titles in many electronic databases, including MEDLINE (via PubMed), SCOPUS, EMBASE,and Google Scholar, utilizing relevant keywords. The utilized keywords comprised: Transaxillary resection - thoracic outlet syndrome -Posterior approach Thoracic outlet decompression - Supraclavicular approach - brachial plexusCompression neuropathy-anterior scalene muscle -Treatment strategy. Results: The rate of success rates (determined as excellent, good, or fair results) for supraclavicular 1st rib excision with scalenectomy (SAFRE), trans axillary 1st rib resection (TAFRR), and rib-sparing scalenectomy (RSS) were 93.2%, 87.9 percent and 97.4 percent respectively (TAFRR vs. SAFRE, P-value <.05; SAFRE verses. RSS, P >.05; RSS vs. TAFRR, P-value<.05. The following surgery DASH scores for each group were as follows: 23.6 (ninety-five percent confidence interval, 18.0, 29.2) for SAFRE, 27.9 (ninety-five percent confidence interval, 14.8, 41.1) for TAFRR, and 13.4 (−9.6, 36.5) for RSS. SAFRE and TAFRR had an overall postoperative CBSQ score of 30.4 (ninety-five percent confidence interval, 7.8, 53.0) and 32.4 (ninety-five percent confidence interval, 23.3, 41.5), respectively. There were statistically insignificant variances in postoperative CBSQ and DASH scores among the groups (P-value>.05). Conclusion: Rib-Sparing Scalenectomy (RSS) has the highest success rate for treating nTOS, with superior outcomes compared to First Rib Resection (FRR), with TAFRR showing better improvement. | ||||
| Keywords | ||||
| Thoracic; RSS; SAFRE | ||||
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