Tratamiento quirúrgico del síndrome del desfiladero torácico: nuestra experiencia (1986-2000)

Summary Objective To assess the results of the surgical treatment of the thoracic outlet syndrome (TOS) in an Angiology and Vascular department. Patients and methods Retrospective study. Period of the study 1986-2000, n=53 cases in 45 patients (8 bilateral). Mean age: 32.6 years (r= 17-58). 29 women (64%) and 16 men (34%), diagnosed by clinical exam, simple radiology and neurophysiology tests, Doppler and angioradiology. Arterial TOS n= 43 (30 pure/13 mixed or neurovascular); venous TOS n= 9 (8 axilosubclavian thrombosis and 1 intermittent edema and 1 case of pure neurogenic TOS). Bone anomalies in 62.2% of patients. 28 cervicalrib/megaapophysis, 19 firstrib, 3 first abnormalrib, 1 clavicle, 1 subclavian muscle resections and 1 isolated scalenectomy were performed. Direct arterial or venous surgery was associated in 8 cases (6/2 respectively). Short and long term results are studied using descriptive statistics, Fisher test and Kaplan-Meier. SPSS program. Results Early results: mortality 0%, morbidity 13%, secondary patency 87.5%. Long term outcome: mean follow-up 36 months (0-15 years). Accumulatedpatency 85.7%. Asymptomatic actuarial ratio 79.2%. Asymptomatic and symptomatic with postoperative negative tests 92.4% (up to 15years). It was not proved any significance between gender, age, type of resection and the clinical persistence (p Conclusions Our results in the surgical treatment of the TOS justify itself. The proper selection is fundamental because a percentage of patients will keep symptoms on in spite of the normalization of the tests.