Long-term Functional Outcomes Follow-Up After 188 Rib Resections in Patients with TOS. Annals of vascular surgery Dua, A., Rothenberg, K. A., Gologorsky, R., Lee, J. T. 2020


INTRODUCTION: Short term outcomes in patients with all forms of TOS have been widely reported in the literature and have established that rib resection can be beneficial in decompressing the thoracic outlet and relieving pressure on traversing structures. We sought to determine long term functional outcomes using the QuickDASH survey in patients with TOS who underwent rib resection.METHODS: Clinical records for patients who underwent rib resection for TOS at a single institution were retrospectively reviewed. All patients were contacted via telephone and long-term functional outcome was assessed at latest follow-up via the 11-item version of the Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Demographics, TOS type, pre-operative QuickDASH score, and athletic status were recorded. Patients were asked if they returned to baseline activity since their surgery, would have the procedure again, and if they were subjectively better postoperatively.RESULTS: From 2000-2018, 261 patients underwent rib resection surgery. 170 (65.1%) were able to be contacted via telephone for long-term follow-up. A total of 188 surgeries (102 nTOS, 82 vTOS, 4 aTOS) were performed in these 170 patients. The mean follow-up time for the cohort was 5.3 years (range 1-18). Overall, 167 (88.9%) of patients returned to baseline activity post-operatively. Postop quickdash decreased to 12 from 44 pre-operatively for the cohort.CONCLUSION: First rib resection and thoracic outlet decompression for all forms of TOS is a durable surgical treatment which results in excellent long term functional outcomes as determined by both the QuickDASH score and subjective patient reporting.

View details for DOI 10.1016/j.avsg.2020.04.033

View details for PubMedID 32335257