Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen
-
Handchir Mikrochir Plast Chir · Feb 2006
Comparative StudyCombined surgical treatment of thoracic outlet syndrome: transaxillary first rib resection and transcervical scalenectomy.
Many different procedures have been developed to treat thoracic outlet compression syndrome (TOCS), a condition in which neurovascular structures in the thoracic outlet region are compressed. Currently, transaxillary first rib resection and transcervical anterior and middle scalenectomy are the most popular and standard procedures. In the early 1980s, some surgeons started to perform both procedures, starting with the scalenectomy and following with a transaxillary first rib resection. We have found that performing these procedures in the reverse order, starting with the first rib resection and following immediately with a transcervical anterior and middle scalenectomy accomplishes total decompression of the thoracic outlet area with much better improvement of symptoms and much lower recurrence rate.
-
The informed consent plays a very decisive part in aesthetic plastic surgery. As there is often no medical indication in plastic surgery, the patient has to be informed about all the facts of an operation, especially about the possible risks. ⋯ The patient needs to be clarified about all facts early enough so that he has a sufficient amount of time to weigh-up the pros und cons of the operation and if necessary to take advice from someone else. The sufficient documentation is very important at the sight of the extensive burden of proof at the expense of the physician.