Thoracic outlet syndrome: diagnosis and management with a new surgical technique.

In 71 patients with thoracic outlet syndrome, the signs and symptoms of which (Table 1) were assessed revealing several findings previously not reported in association with this condition, 119 surgical procedures were performed according to a newly-developed technique described in this paper. As compared with a substantial number of unsuccessful early and late outcomes rendered through first-rib resection or scalenectomy, the new technique, scalenotomy, led to excellent results in 100% of all cases (Table 2). No complications were seen and no recurrences were observed during an average follow-up period of one year. An additional finding was that, on use of the new technique, even in the presence of a symptomatic cervical rib or hypoplastic first thoracic rib, resection was not necessary to provide the patients with complete recovery from the syndrome.