RT Book, Section
A1 Lee, Fred
A1 Burt, Bryan M.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170415362
T1 Thoracic Outlet Syndrome
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170415362
RD 2024/04/23
AB Thoracic  outlet  syndrome  (TOS)  encompasses  a  trio  of  conditions  that  result  from  compression  of  the  neurovascular  structures  that  serve  the  upper  extremity:  the  brachial  plexus  (neurogenic  thoracic  outlet  syndrome),  the  subclavian  vein  (venous  TOS),  and  the  subclavian  artery  (arterial  TOS),  and  each  syndrome  is  defined  by  a  distinct  presentation.  The  name  TOS  was  previously  designated  according  to  the  etiology  of  the  compression—that  is,  scalenus  anticus,  costoclavicular,  hyperabduction,  cervical  rib,  or  first  rib  syndrome.  Most  compressive  factors  operate  against  the  first  rib  and  produce  a  variety  of  symptoms,  depending  on  which  neurovascular  structures  are  compressed.  These  factors,  along  with  common  etiologies  and  symptoms,  are  illustrated  in  Figure  143-1.  This  chapter  will  review  the  anatomy  and  pathophysiology  of  thoracic  outlet  syndrome  and  the  transaxillary  approach  to  first  rib  resection.  Subsequent  chapters  will  detail  other  surgical  approaches  to  first  (and  cervical)  rib  resection  including  supraclavicular  (Chapter  144)  and  thoracoscopic  approaches  (Chapter  145)  and  will  address  the  vascular  interventions  often  additionally  required  for  venous  TOS.