Adolescent athletes can get back in the game after surgery for thoracic outlet syndrome

• DOI: 10.1016/j.jvs.2022.10.002
• Publication Date: 2022-10-12T11:08:39Z
• Authors: Stephanie D. Talutis; Jesus G. Ulloa; Hugh A. Gelabert
• Keywords: Decompression; Male; Adolescent; Clinical Sciences; Pain; Neurogenic; Clinical sciences; Ribs; Outcomes; Paget-Schroetter; Medical and Health Sciences; Cardiovascular medicine and haematology; 7.3 Management and decision making; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Surgical; Humans; Postoperative; Retrospective Studies; Pediatric; Pain, Postoperative; Biomedical and Clinical Sciences; Pain Research; Decompression, Surgical; 3. Good health; Thoracic outlet; Thoracic Outlet Syndrome; Treatment Outcome; Cardiovascular System & Hematology; Athletes; Female; Patient Safety; Management of diseases and conditions

We compared the functional outcomes among adolescent athletes with venous thoracic outlet syndrome (VTOS) and neurogenic TOS (NTOS) after decompression.We performed a single-institution retrospective review of prospective database (aged 13-19 years) from June 1, 1996 to December 31, 2021 who had undergone operative decompression for TOS. The demographic data, preoperative symptoms, details, postoperative were compared. primary outcome was return sport. secondary included symptom resolution assessment somatic pain scale, QuickDASH, Derkash scores. Fisher exact test t used evaluate categorical continuous variables, respectively. A logistic regression model constructed adjust influence factors sport.A total 60 patients (40.0% VTOS 60.0% NTOS) included. average age 17.2 years vs 16.6 NTOS (P = .265). more likely be female (88.9% 62.5%; P .024). frequently presented (97.2% 70.8%; .005), paresthesia (94.4% 29.1%; .021), weakness (67.7% 12.5%; .004) but less often reported swelling (25.0% 95.8%; < .001). At presentation, also longer duration (17.7 months 3.1 months; Transaxillary first rib resection subtotal scalenectomy 100% 94.4% undergoing cervical (2.8%) or alone (2.8%). Additionally, 11.1% combined resection. For patients, venography showed patent subclavian veins in 27.8%. In addition, 44.4% required venoplasty, 16.8% thrombolysis, 11% chronically occluded. No significant differences found blood loss, time, length stay between groups. surgical complications occurred. follow-up 6.3 months. Significant groups pre- Complete occurred 83.3% 75% .074). statistically difference sport observed two (VTOS, 94.4%; NTOS, 73.9%; .123). Of 10.0% other concomitant injuries 5.0% medical conditions that precluded their Logistic no relationship scale score, QuickDASH symptoms sport.Adolescent can have good outcomes, most will able surgery. Greater initial severity adolescents NTOS. those not returned postoperatively, three seven unrelated health issues prevented