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Residual Symptom Analysis After the Subtotal Anterior and Middle Scalenectomy for Disputed Thoracic Outlet Syndrome: Comparison Between Surgical and Untreated Patients

Gong, Xu MD, PhD; Jiang, Zhen Min MD; Lu, Lai Jin PhD, MD

doi: 10.1097/SAP.0000000000000944
Peripheral Nerve Surgery and Research

Objective: There are significant differences in the results on disputed thoracic outlet syndrome (TOS) surgery, which reflect that not all patients with disputed TOS are amenable to surgery. It is necessary to find out appropriate indicators for screening of patients who are suitable for surgery. Pain and paresthesia are 2 prominent symptoms of disputed TOS. The purpose of this study was to identify which symptoms could be removed by surgery.

Methods: Data for all patients with disputed TOS who were admitted and prepared for surgical treatment between July 2008 and April 2012 were collected. The patients were divided into the surgical group and untreated group. The patients in the untreated group actively gave up surgical treatment due to fear of surgery after admission. The follow-up was obtained by standard visits with the clinician and by telephone interviews.

Results: There were 10 patients (unilateral TOS) in the surgical group and 5 (3 bilateral TOS) in the untreated group. Statistical analysis showed no significant differences in age, sex, duration of symptoms, the types of symptoms, positive signs and provocative tests on physical exam, and length of follow-up between 2 groups. As for paresthesia, statistically significant difference was detected between the preoperative and postoperative surgical group (P < 0.001) and between the surgical and untreated group (P = 0.002). With regard to pain, there was no statistically significant difference between the preoperative and postoperative surgical group (P = 0.350) and between the surgical and untreated group (P = 0.251). However, the degree of pain was tolerable in both groups.

Conclusions: Our preliminary results revealed that the surgery is effective for the paresthesia as the main symptoms of the patients, but is invalid for the pain as the main symptoms.

From the Department of Hand Surgery, The First Hospital of Ji Lin University, Chang Chun, 130021, China.

Received June 10, 2016, and accepted for publication, after revision September 21, 2016.

Conflicts of interest and sources of funding: none declared.

Reprints: Xu Gong, MD, PhD and Lai Jin Lu, MD, PhD, Department of Hand Surgery, The First Hospital of Ji Lin University, Chang Chun, China. 130021. E-mail: 15843079656@163.com.

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