Surgical outcomes for occluded venous thoracic outlet syndrome following transaxillary first rib resection.

Objective: Surgical decompression via transaxillary first rib resection (TFRR) is often performed in patients presenting with venous thoracic outlet syndrome (VTOS). We aimed to evaluate the outcomes of TFRR based on chronicity of completely occluded axillosubclavian veins in VTOS.

Methods: We performed a retrospective institutional review of all patients who underwent TFRR for VTOS and had a completely occluded axillosubclavian vein between 2003 and 2022.

The Blue Ribbon Committee II Report and Recommendations on Surgical Education and Training in the United States: 2024.

Objective: An expert panel made recommendations to optimize surgical education and training based on the effects of contemporary challenges.

Background: The inaugural Blue Ribbon Committee (BRC I) proposed sweeping recommendations for surgical education and training in 2004. In light of those findings, a second BRC (BRC II) was convened to make recommendations to optimize surgical training considering the current landscape in medical education.

Goals, Structure, and Financing of Surgical Residency Training: A Subcommittee Report of the Blue Ribbon Committee II.

Objective: As part of the Blue Ribbon Committee II, review current goals, structure and financing of surgical training in Graduate Medical Education (GME) and recommend needed changes.

Background: Surgical training has continually undergone major transitions with the 80-hour work week, earlier specialization (vascular, plastics, and cardiovascular), and now entrustable professional activities as part of competency-based medical education (CBME). Changes are needed to ensure the efficiencies of CBME are utilized, that stable graduate medical education funding is secured, and that support for surgeons who teach is made available.

Blue Ribbon Committee I Review: Findings and Impact.

Objective: Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education.

Background: Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education.

Methods: BRC I members reviewed the 2004 recommendations in light of the current status of surgical education.

The Aging Surgeon: Considerations for Navigating a Successful and Satisfying Career.

Our careers as surgeons are some of the busiest and perhaps most sought after in existence. We have all put in countless years of tenacious effort, at times blood, frequent sweat, and occasional tears, to have the privilege to care for others and correct their ailments. Many of us are like freight trains rolling down the tracks indefinitely.

Double Trouble: Combined Neurogenic Thoracic Outlet Syndrome and Superior Labrum Anterior Posterior Tear.

Neurogenic thoracic outlet syndrome and superior labrum anterior posterior tears are usually treated in a staged manner due to different post-operative therapy needs. This case describes successful combined surgery with expedited physical therapy.

Boney abnormalities cause arterial, venous, and/or neurogenic thoracic outlet syndrome.

Background: Thoracic outlet syndrome (TOS) is a rare condition caused by compression of the neurovascular structures within the thoracic outlet. Different classifications of TOS exist depending on the neurovascular structure being compressed: neurogenic, venous, or arterial. Any of these forms can present independently or coexist with one other.

Delay in Diagnosis for Two Patients With McCleery Syndrome.

McCleery syndrome is a rare form of venous thoracic outlet syndrome characterized by intermittent obstruction of the subclavian vein (SCV) without thrombosis. In 2022, two patients presented to our clinic with McCleery syndrome after living with venous symptoms for over one year. Duplex scans of both patients revealed compression of the SCV on abduction.

Translating the Value of the Academic Surgeon Into Salary, Time, and Resources.

Academic surgeons provide tremendous value to institutions including notoriety, publicity, cutting-edge clinical advances, extramural funding, and academic growth and development. In turn, these attributes may result in improved reputation scores and hospital or medical center rankings. While many hospital systems, schools of medicine, and departments of surgery claim to have a major commitment to academic surgery and research, academic surgeons are often undercompensated compared to clinically focused counterparts.

Effect of preservation of antegrade hypogastric flow on development of claudication following aortoiliac aneurysm repair.

Objective: The objective of this study was to compare the rate of development of buttock claudication in patients undergoing aortoiliac aneurysm repair with and without exclusion of antegrade hypogastric arterial flow. In the absence of convincing data, questions remain regarding the best management of hypogastric arterial flow to prevent the theoretical risk of buttock claudication.

Methods: The Veterans' Affairs Open Versus Endovascular Repair (OVER) Cooperative Study prospectively collected information on buttock claudication.

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis.

Background: Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada.

Anterior Scalene Anomaly in a Patient With Arterial and Neurogenic Thoracic Outlet Syndrome.

Compression of the neurovascular structures of the upper extremity as they pass through the thoracic outlet result in thoracic outlet syndrome. The myriad of symptoms associated with the syndrome vary based on the structure(s) compressed: the subclavian artery/vein or the inferior trunk of the brachial plexus. This is a common site of compression especially in the presence of upper extremity injury, overuse or anatomical abnormalities.

Excellent results seen with both transaxillary and infraclavicular approaches to first rib resection in patients with subclavian vein thrombosis.

Background: Venous thoracic outlet syndrome (VTOS) is a debilitating condition with several well-documented treatment paradigms. We reviewed the outcomes from a large academic institution of patients who had undergone transaxillary first rib resection with delayed venography (TA) or infraclavicular first rib and subclavius muscle resection with concomitant venography (ICV) for VTOS with subclavian vein thrombosis.

Methods: We performed a retrospective review of the medical records of all patients who had undergone first rib resection and scalenectomy for VTOS with subclavian vein thrombosis at a single academic institution.

A Rare Case of Bilateral Neurogenic Thoracic Outlet Syndrome Following Neck Injury.

Thoracic Outlet Syndrome (TOS) is a rare condition caused by compression of the neurovascular structures of the thoracic outlet. Patients with TOS are found to have a greater prevalence of supernumerary or abnormal first ribs compared to the general population. Symptoms can sometimes be incited by a neck injury, especially in patients with abnormal cervical anatomy.