内窥镜辅助下手术治疗上干型胸廓出口综合征

Treatment of Upper Plexus Thoracic Outlet Syndrome by Endoscope Assisted Operation

目的报告内窥镜辅助下手术治疗上干型胸廓出口综合征的新方法.方法为9例上干型胸廓出口综合征患者局麻下通过颈外侧区作长1.5 cm切口,在内窥镜辅助下切断部分前、中斜角肌的腱性起始纤维.结果术后随访4个月～2年.按Wood等的评定标准评价:优6例,良2例,可1例.结论在内窥镜辅助下经颈部微小切口切断部分前、中斜角肌的腱性起始纤维可解除斜角肌对臂丛神经的压迫,是一种治疗上干型胸廓出口综合征的有效微创手术方法.

Purpose To report a new treatment method of upper plexus thoracic outlet syndrome assisted by endoscope. Methods Nine patients suffered from upper plexus thoracic outlet syndrome was operated in this way: after local block,an incision 1.5 cm in length was made at the lateral neck,the tendon-like origin fiber of anterior and middle scalene muscles was cut partially under the endoscope. Results Follow up was 4 months to 2 years.According to assessment standard described by wood,treatment outcome was excellent in 6 case,good in 2 case,general in 1 case. Conclusions Partial resection of the origin parts of anterior and middle scalene muscle with minor incision at the neck assisted by endoscope is a new way with minimal trauma for treatment of upper plexus thoracic outlet syndrome,which can relieve the compression of the brachial plexus by the scalene muscles.