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Long-Term Functional Outcome of Surgical Treatment for Thoracic Outlet Syndrome.

Long-Term Functional Outcome of Surgical Treatment for Thoracic Outlet Syndrome.
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Peek J, Vos CG, Ünlü Ç, Schreve MA, van de Mortel RHW, de Vries JPM,


Peek J, Vos CG, Ünlü Ç, Schreve MA, van de Mortel RHW, de Vries JPM, (click to view)

Peek J, Vos CG, Ünlü Ç, Schreve MA, van de Mortel RHW, de Vries JPM,

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Diagnostics (Basel, Switzerland) 2018 01 128(1) pii E7
Abstract

First rib resection for thoracic outlet syndrome (TOS) is clinically successful and safe in most patients. However, long-term functional outcomes are still insufficiently known. Long-term functional outcome was assessed using a validated questionnaire. A multicenter retrospective cohort study including all patients who underwent operations for TOS from January 2005 until December 2016. Clinical records were reviewed and the long-term functional outcome was assessed by the 11-item version of the Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Sixty-two cases of TOS in 56 patients were analyzed: 36 neurogenic TOS, 13 arterial TOS, 7 venous TOS, and 6 combined TOS. There was no 30-day mortality. One reoperation because of bleeding was performed and five patients developed a pneumothorax. Survey response was 73% (n = 41) with a follow-up ranging from 1 to 11 years. Complete relief of symptoms was reported postoperatively in 27 patients (54%), symptoms improved in 90%, and the mean QuickDASH score was 22 (range, 0-86). Long-term functional outcome of surgical treatment of TOS was satisfactory, and surgery was beneficial in 90% of patients, with a low risk of severe morbidity. However, the mean QuickDASH scores remain higher compared with the general population, suggesting some sustained functional impairment despite clinical improvement of symptoms.

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