经腋路内窥镜辅助下切除第一肋骨治疗胸廓出口综合征

目的 报告内窥镜辅助下手术治疗下干型胸廓出口综合征的方法及临床疗效.方法 采用内窥镜辅助下经腋路第一肋骨切除术治疗下干型胸廓出口综合征14例.结果 术后随访时间为12～24个月,14例患者症状完全解除,未见复发.4例第一骨间背侧肌萎缩者,有2例完全恢复,2例部分恢复.按照Wood等提出的评价标准评定:优11例(占78.6%).良3例(占21.4%).结论 经腋路内窥镜辅助下切除第一肋骨治疗下干型胸廓出口综合征,手术创伤小.伤口隐蔽,减压彻底,疗效满意.

Endoscope assisted transaxillary first rib resection for the treatment of thoracic outlet syndrome

Objective To report a method and clinical effect of endoscope assisted surgery for treatment of lower trunk type thoracic outlet syndrome.Methods fourteen cases of lower plexus type thoracic outlet syncLrome were treated with transaxillary first nb reaction assisted by endoscope.Results All the eases were followed for 12 to 24 months postoperatively.Symptoms were relieved in all of the 14 cases and there was no one recurrence.For the 4 eases with muscle atrophy of the first dorsal interosscous muscle,complete restoration was achieved in 2 cases and partial restoration in 2 cases.According to Wood's evaluation criteria,the results were rated as excellent in 11 cases (78.6%) and good in 3 cases (21.4%).Conclusion Endoscopoe assisted transsxillary first rib resesction is an optimal procedure for the treatment of thoracic outlet syndrome.It is minimally invasive with a small and concealed incision.It achieves complete decompression,which leads to low recurrent rate and satisfactory results.