Thoracic Outlet Compression Syndrome

Abstract

Summary This is a retrospective  study of 45 patients with Thoracic Outlet Compression Syndrome who were treated surgically in the department of Thoracic & Cardiovascular Surgery at the  "Medical City Teaching Centre – Specialized Surgeries Hospital" , from January 1^st, 1997 to December 31^st ,2006. They are studied according to their age , sex , causative factors , clinical features , side of affection and compliance , diagnostic measures , theraputic planing , surgical approaches , and surgical outcomes. We compare our results with four different studies ; one from the same centre in Iraq done in 1993 , and the other three studies taken from centres  in  the  United States  of  America , Turkey, and India & done in 1998 , 2003 , & 2004 respectively. Our study agreed with the other studies that TOCS is more common in female than male , more common in the 3^rd & 4^th  decades of life , more on the right than the left side , mostly caused by cervical rib , and more with neurological manifestations. There are four different approaches for the surgical treatment of TOCS ; posterior approach , anterior approach , transaxillary approach , and double route approach. In our study 98% of the surgical treatment was performed through the posterior approach , we compare the advantages and disadvantages of this approach with the other approaches in the four different studies mentioned. The Thoracic Outlet Compression Syndrome (TOCS) is a group of common conditions caused by compression of the nerves & vessels supplying the upper limb. Symptoms vary from mild to limb threatening , it might be missed or ignored by many physicians as they mimic common  conditions  such as tension headache or fatigue syndromes. Clinical diagnosis, appropriate investigations and surgery, especially if reserved for carefully selected patients, yield satisfying and sometimes dramatic results ¹