Eight patients with axillary-subclavian vein thrombosis were studied. Three presented acutely and five with chronic symptoms of pain and swelling exacerbated by and limiting normal use. Initial venography showed complete occlusion of the axillary vein in 7 cases and marked narrowing in the remaining patient. Venographic evidence of narrowing or occlusion was also seen in 6/8 clinically normal contralateral arms. One of these arms became symptomatic 2 years later, and required surgery. The patients presenting acutely were anticoagulated. Symptoms resolved slowly in 2 cases, but persisted in one. This patient and the five presenting chronic symptoms underwent decompression of the thoracic outlet by transaxillary resection of the first rib. Satisfactory decompression was confirmed at operation by eliciting and then abolishing "nipping" of the surgeon's finger between the first rib and the clavicle on abducting and then relaxing the arm. Symptomatic relief was achieved in 5/7 limbs thus treated (one patient had bilateral first rib resection). Although postoperative venographic improvement was seen in some cases, clinical success did not depend on recanalisation of the main axillary-subclavian vein. The two patients with persistent symptoms after first rib resection subsequently had venous bypass procedures. Despite initial patency, both had occluded with return of symptoms within 4 months.
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http://dx.doi.org/10.1016/s0950-821x(87)80017-8 | DOI Listing |
Front Oncol
January 2025
Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
Chondrosarcoma-like malignant giant cell tumor (GCT) of the rib is an extremely rare and aggressive tumor, particularly in adolescents. This case report describes a 19-year-old female presenting with a GCT of the rib with chondrosarcomatous differentiation, highlighting the challenges posed by its unusual location and pathological complexity. Multidisciplinary diagnostic approaches, including advanced imaging, immunohistochemistry (IHC), and pathology, were essential for confirming the diagnosis.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Thoracic Surgery, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, Jiangsu, China.
Background: Fibrous dysplasia (FD) is the most common benign tumor of the ribs, with surgical resection being the preferred treatment modality for rib FD, leading to enhanced quality of life and favorable outcomes. The complexity of surgical intervention varies depending on the location of costal FD, presenting challenges for both open surgical and thoracoscopic approaches. In this study, we present a novel technique for three-port robotic-assisted costectomy utilizing a Gigli saw, detailing our initial findings and outcomes.
View Article and Find Full Text PDFJ Clin Med
January 2025
My Houston Surgeons, 9230 Katy Freeway, Suite 600, Houston, TX 77055, USA.
Removal of the rib and adjacent cartilage is a common step for exposure of the recipient chest vessels in free-flap breast reconstructions. However, this adds both short- and long-term morbidity to the procedure. We describe our experience in avoiding rib removal in microvascular breast reconstruction.
View Article and Find Full Text PDFJ Clin Med
January 2025
Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Thoracic outlet syndrome (TOS) is an uncommon condition defined by the compression of neurovascular structures within the thoracic outlet. When conservative management strategies fail to alleviate symptoms, surgical decompression becomes necessary. The purpose of this study is to evaluate and compare the efficacy and safety of regional anesthesia (RA) using spontaneous breathing in contrast to general anesthesia (GA) for patients undergoing surgical intervention for TOS.
View Article and Find Full Text PDFIntroduction: Solitary plasmacytomas are tumors characterized by a local increase of malignant plasma cells in soft tissue or bone and may occur anywhere without evidence of systemic disease. The aim was to focus on the main surgical techniques and outcomes for this rare chest wall tumor.
Methods: Patients with solitary plasmacytoma involving a rib, who were operated for diagnostic or treatment purposes between 2018 and 2023 were retrospectively reviewed.
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