The purpose of this study was to evaluate the results of the surgical treatment of the thoracic outlet syndrome.

Between 1990–2002, 46 patients, 15 male and 31 female aged ranging from 23 to 49 years old (mean age 34 years) underwent decompressive surgery of the thoracic outlet syndrome. Some 9 patients required bilateral operations. Symptoms due to compression of neural elements were present in 23 patients, of vascular elements in 12 patients and of both elements in 11 patients. The duration of symptoms was less than 2 years in 25 patients and 2 to 6 years in 21 patients. Operations consisted of scalenectomy in 47 cases with brachial plexus neurolysis for neurogenic indication, release of the pectoralis minor muscle insertion in 5 cases and cervical rib resection in 3 cases.

The follow up period ranged from 1 to 12 years (mean 5 years). The results were classified as excellent with symptoms elimination in 27 cases, good with symptoms significant improvement in 19 cases and poor with symptoms persistent or aggravation in 9 cases. First rib resection in 4 patients with poor results and release of the pectoralis minor muscle insertion in 1 patient leaded to significant improvement of their symptoms. Some 90% of patient with symptoms less than 2 years had a successful result compared with only 76% in those with symptoms longer than 2 years. Complications included pneumothorax in one case and temporary phrenic nerve palsy in another case.

A selective surgical decompression of the thoracic outlet syndrome yields satisfactory results in appropriately selected patients.