Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492012000300009
Jornal Vascular Brasileiro
Innovation

Síndrome do desfiladeiro torácico - ressecção de costela cervical por videotoracoscopia

Thoracic outlet syndrome - cervical rib resection through videothoracoscopic surgery

Mario Claudio Ghefter; Winston Bonetti Yoshida; Daniele Cristina Cataneo; Erica Nishida Hasimoto; Ricardo Alvarenga Yoshida; Paulo Cesar Buffara Boscardim; Antonio José Maria Cataneo

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Resumo

A base do tratamento cirúrgico da Síndrome do Desfiladeiro Torácico (SDT) é a ressecção da primeira costela, podendo associar-se à escalenectomia ou ainda à ressecção de costela cervical. Esta última é feita tradicionalmente por meio de um acesso supraclavicular ou mesmo axilar, o qual é tecnicamente mais trabalhoso. Pode ser realizada também por meio de acesso paraescapular. Embora tecnicamente atrativa e associada à menor invasividade e maior segurança, com ótimo resultado estético, a ressecção da primeira costela torácica, por intermédio de cirurgia videoassistida transaxilar ou pela técnica videotoracoscópica, é pouco relatada na literatura, e nenhuma referência foi encontrada sobre ressecção de costela cervical mediante essa técnica. Neste artigo, apresentamos essa inovação cirúrgica realizada com sucesso para ressecção de costela cervical em duas pacientes.

Palavras-chave

cirurgia vídeo-assistida, costela cervical, Síndrome do Desfiladeiro Torácico, Síndromes de Compressão Nervosa

Abstract

The basis of Thoracic Outlet Syndrome (TOS) surgical treatment is the first rib resection and may be associated with scalenectomy or cervical rib resection. The latter is traditionally done through a supraclavicular or axillary access, which is the most technically challenging. It can also be achieved through parascapular access. Although technically attractive and associated with less invasiveness and increased security, with excellent aesthetic results, the first thoracic rib resection via video-assisted transaxillary surgery or videothoracoscopic technique is seldom reported in the literature, and no reference was found on cervical rib resection through this technique. In this article, we introduced this innovation successfully performed for surgical cervical rib resection in two patients.

Keywords

video-assisted surgery, cervical rib, Thoracic Outlet Syndrome, Nerve Compression Syndromes

References

Mackinnon SE, Novak CB. Thoracic outlet syndrome. Curr Probl Surg. 2002;39:1070-145.

Povlsen B, Belzberg A, Hansson T, Dorsi M. Treatment for thoracic outlet syndrome. Cochrane Database Syst Rev. 2010;20.

Thompson RW, Petrinec D, Toursarkissian B. Surgical treatment of thoracic outlet compression syndromes: II. Supraclavicular exploration and vascular reconstruction. Ann Vasc Surg. 1997;11:442-51.

Urschel HC, Kourlis H. Thoracic outlet syndrome: a 50-year experience at Baylor University Medical Center. Proc (Bayl Univ Med Cent). 2007;20:125-35.

Sanders RJ, Hammond SL, Rao NM. Diagnosis of thoracic outlet syndrome. J Vasc Surg. 2007;46:601-4.

Martinez BD, Wiegand CS, Evans P, Gerhardinger A, Mendez J. Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach. Vascular. 2005;13:327-35.

Ohtsuka T, Wolf RK, Dunsker SB. Port-access first-rib resection. Surg Endosc. 1999;13:940-2.

Barkhordarian S. First rib resection in thoracic outlet syndrome. J Hand Surg Am. 2007;32:565-70.

Sanders RJ. Thoracic outlet syndrome: general considerations. Rutherford's vascular surgery. 2010;2:1865-77.

Jordan SE, Ahn SS, Freischlag JA, Gelabert HA, Machleder HI. Selective botulinum chemodenervation of the scalene muscles for treatment of neurogenic thoracic outlet syndrome. Ann Vasc Surg. 2000;14:365-9.

Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg. 2002;36:51-6.

Urschel Jr HC. Dorsal sympathectomy and management of thoracic outlet syndrome with VATS. Ann Thorac Surg. 1993;56:717-20.

Morgan CJ, Lyons J, Ling BC, Maher PC, Bohinski RJ, Keller JT. Video-assisted thoracoscopic dissection of the brachial plexus: cadaveric study and illustrative case. Neurosurgery. 2006;58:287-90.

Araujo LF, Moreschi AH, Macedo GB, Moschetti L, Machado EL, Saueressig MG. Chylothorax after surgical treatment of right-sided thoracic outlet syndrome. J Bras Pneumol. 2009;35:388-91.

Candia-de la Rosa RF, Pérez-Rodríguez A, Candia-García R, Palacios-Solís JM. Endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe surgical option. Cir Cir. 2010;78:53-9.

Jancovici R, Lang-Lazdunski L, Pons F, Cador L, Dujon A, Dahan M. Complications of video-assisted thoracic surgery: a five-year experience. Ann Thorac Surg. 1996;61:533-7.

Szego T, Roll S, Nogueira Filho WS, Bensenor F. Videolaparoscopic cholecystectomy: Report of the first Brazilian series. Arq Gastroenterol. 1991;28:6-8.

Barbosa CP, Moscovitz T, Martins NV, Souza AMB, Soubhia IT, Aldrighi APS. Abordagem laparoscópica do câncer de endométrio. Rev Bras Ginecol Obstet. 1999;21:41-5.

Juliano RV, Bezerra CA, Barbosa CP, Wroklawski ER. Sistematização do ensino em cirurgia videolaparoscópica em Urologia. J Bras Urol. 1993;19.

Yoshida RA, Yoshida WB, Rollo HA, Kolvenbach R, Jaldim RG, Pimentel FC. Total laparoscopic aortic surgery for treatment of limb critical ischemia: report of the first case in Brazil. J Vasc Bras. 2010;9:66-73.

Rodrigues OR, Losso LC, Ghefter MC, Imaeda CJ, Jatene FB, Filomeno LTB. Thoracoscopic surgery in Brazil: An overview. J Cardiovasc Surg (Torino). 1996;37:147-53.

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