Novosti
Khirurgii
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indexed in Scopus



Year 2014 Vol. 22 No 4

GENERAL AND SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2014.4.449   |  

D.D. SULTANOV1,2, F.M. TUHTAEV 1, N.R. KURBANOV 2

TRANSAXILLARY FIRST RIB RESECTION AT COSTOCLAVICULAR SYNDROME

Republican Scientific Center of Cardiovascular Surgery of Ministry of Health and Social Protection of the Republic of Tajikistan1
Avicenna Tajik State Medical University2, Dushanbe
The Republic of Tajikistan

Objectives. To improve the method of transaxillary first rib resection at the costoclavicular syndrome (CCS).
Methods. The results of survey and surgical treatment of patients (n=77) with Falconer-Weddell costoclavicular syndrome have been analyzed.
The tests of Edson, Lange, Roos, Wright have been carried out to reveal the signs of compression of the neurovascular bundle (NVB) and differentiation of the compression level. Neurological tests have been defined for neurological disorders. In patients with the secondary Raynaud's syndrome to predict the outcome of operation the cold and nitroglycerine tests were done. Methods of investigations included Doppler ultrasound and X-ray examinations. In 58 (75,3%) of 77 patients with CCS the signs of Raynaud's syndrome were observed besides the enumerated symptoms. All patients were operated on under endotracheal anesthesia. Decompression operations have been conducted in all patients (n=77); selective cervico-thoracic sympathectomy in 58 cases.
Results. The pleura damage during the operation was registered in 4 (5,2%) patients. Non-specific complications such as hemothorax (n=1) and wound bleeding after surgery with festering it further (n=1) have been occurred. In the postoperative period the brachial plexitis manifested by pain in the arm and neck regions which was stopped with anti-inflammatory, anesthetic agents was observed in 3 patients. All above-mentioned complications were transient in 9 (11,7%) patients. The gradual regression of the neurological symptoms and arterial disturbances was noticed. In the long-term period the positive results were registered in all operated patients, the certain symptoms were recurred in some of them in winter season.
Conclusions. Transaxillary first rib resection despite of some technical difficulties of performance is considered as a highly-effective and pathogenetically grounded method of costoclavicular syndrome treatment. The decompression effect has been achieved on all three anatomically narrow for compression areas.

Keywords: costoclavicular syndrome, thoracic outlet syndrome, surgical treatment
p. 449 456 of the original issue
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Address for correspondence:
34003, Respublika Tadzhikistan, g. Dushanbe, ul. Sanoi, d. 33, Tadzhikskiy gosudarstvennyiy meditsinskiy universitet im. Abuali ibni Sino, kafedra khirurgicheskih bolezney,
e-mail: sultanov57@mail.ru,
Sultanov Dzhavli Davronovich
Information about the authors:
Sultanov D.D. MD, professor of the chair of surgical diseases 2 of Avicenna Tajik State Medical University, a head of the Science department of Republican Scientific Center of Cardiovascular Surgery.
Tuhtaev F.M. A post-graduate student of Republican Scientific Center of Cardiovascular Surgery.
Kurbanov N.R. PhD, an assistant of the chair of surgical diseases 2 of Avicenna Tajik State Medical University.
Contacts | ©Vitebsk State Medical University, 2007