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Improvement of Disability in Neurogenic Thoracic Outlet Syndrome by Robotic First Rib Resection.
Palivela, Nihanth; Lee, Hyun-Sung; Jang, Hee-Jin; Paily, Paul; Montero, Miguel; Najafi, Bijan; Burt, Bryan M.
Afiliación
  • Palivela N; Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • Lee HS; Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • Jang HJ; Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • Paily P; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas.
  • Montero M; Division of Vascular and Endovascular Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • Najafi B; Division of Vascular and Endovascular Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • Burt BM; Division of Thoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas. Electronic address: bryan.burt@bcm.edu.
Ann Thorac Surg ; 114(3): 919-925, 2022 09.
Article en En | MEDLINE | ID: mdl-34419432
BACKGROUND: Robotic transthoracic first rib resection (R-FRR) has advantages over traditional approaches; however, its impact on postoperative neurogenic thoracic outlet syndrome (nTOS) outcomes is unknown. Our primary objective was to determine improvement of patient-reported outcome measures (PROMs) of pain and disability after R-FRR in nTOS. Our secondary objective was to compare improvement of patient-reported pain between R-FRR and supraclavicular FRR (SC-FRR) in nTOS. METHODS: We queried a prospectively maintained, single-surgeon, single-institution database for patients with nTOS undergoing R-FRR or SC-FRR with available preoperative and postoperative PROMs. PROMs included the Disability of the Arm, Hand, and Shoulder (DASH) questionnaire and visual analog scale (VAS) for pain. RESULTS: Cohort 1 included 37 patients (32 women) undergoing 40 R-FRRs, with an average age of 36 years. Preoperative VAS and DASH (6.0 and 64.2, respectively) improved significantly at the first (2.8 and 35.0; P < .001 for both) and second postoperative visits (1.4 and 30.2; P < .01 for both) which occurred at 2.6 and 15.3 weeks, respectively. Cohort 2 included 57 R-FRRs performed in 53 patients and 35 SC-FRRs performed in 34 patients. The R-FRR and SC-FRR groups did not significantly differ in sex, age, hand dominance, TOS laterality, or preoperative VAS. At the first postoperative visit (2.4 weeks), R-FRR was associated with lower VAS scores (P = .023) and greater VAS improvement than SC-FRR (53% and 27% decrease, respectively; P = .008). CONCLUSIONS: R-FRR results in significant improvement in disability and pain in nTOS and may have a greater impact on patient-reported pain than SC-FRR in the early postoperative period.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Desfiladero Torácico / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans Idioma: En Revista: Ann Thorac Surg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Desfiladero Torácico / Procedimientos Quirúrgicos Robotizados Tipo de estudio: Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adult / Female / Humans Idioma: En Revista: Ann Thorac Surg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos