{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:57:16Z","timestamp":1761058636100},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[1991,10,1]],"date-time":"1991-10-01T00:00:00Z","timestamp":686275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1991,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>There is some disagreement about whether the first rib should be excised in the presence of a cervical rib for the relief of the thoracic outlet compression syndrome (TOCS). Over a 14-year period (1975\u20131988) 58 patients have undergone surgery for TOCS. Forty-four patients (76 per cent) had vascular symptoms, 28 (48 per cent) with a neurological component; 11 (19 per cent) had only neurological symptoms. Thirty-six patients (62 per cent) had the first rib excised; 19 (33 per cent) had a cervical rib excised; two (3 per cent) had a division of fibrous bands; and one patient had a large transverse process resected. Follow-up details were available on 53 patients (91 per cent). Overall 38 (72 per cent) were cured of their symptoms, 11 (21 per cent) had a significant improvement, and four (8 per cent) showed no improvement. There was no significant difference between the results following excision of a cervical rib or of a first rib in terms of relief of symptoms. In patients with TOCS who have a cervical rib, excision of the cervical rib alone without excision of the first rib would appear to be an appropriate treatment.<\/jats:p>","DOI":"10.1002\/bjs.1800781015","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T15:36:45Z","timestamp":1172936205000},"page":"1193-1195","source":"Crossref","is-referenced-by-count":28,"title":["Surgical management of the thoracic outlet compression syndrome"],"prefix":"10.1093","volume":"78","author":[{"given":"A H","family":"Davies","sequence":"first","affiliation":[{"name":"Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital , Headington, Oxford,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Walton","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital , Headington, Oxford,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Stuart","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital , Headington, Oxford,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Morris","sequence":"additional","affiliation":[{"name":"Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital , Headington, Oxford,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1991,10,1]]},"reference":[{"key":"2024092809014315600_bib1","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/S0140-6736(02)44765-4","article-title":"Exostosis of the left transverse process of the seventh cervical vertebra surrounded by blood vessels and nerves: successful removal","volume":"i","author":"Coote","year":"1861","journal-title":"Lancet"},{"key":"2024092809014315600_bib2","first-page":"263","article-title":"Lesion of the first dorsal nerve root","volume":"1","author":"Bramwell","year":"1903","journal-title":"Rev Neurol Psychiatry"},{"key":"2024092809014315600_bib3","first-page":"1274","article-title":"Thoracic outlet compression syndrome","volume":"i","author":"Gilliat","year":"1976","journal-title":"Br Med J"},{"key":"2024092809014315600_bib4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1002\/bjs.1800750512","article-title":"Results of excision of a cervical rib in patients with the thoracic outlet syndrome","volume":"75","author":"Brown","year":"1988","journal-title":"Br J Surg"},{"key":"2024092809014315600_bib5","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/bjs.1800770529","article-title":"First rib resection for vascular complications of the thoracic outlet syndrome","volume":"77","author":"Thompson","year":"1990","journal-title":"Br J Surg"},{"key":"2024092809014315600_bib6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/00000441-190702000-00001","article-title":"The symptomatology, diagnosis and surgical treatment of cervical ribs","volume":"133","author":"Keen","year":"1907","journal-title":"Am J Med Sci"},{"key":"2024092809014315600_bib7","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1084\/jem.24.3.271","article-title":"An experimental study of circumscribed dilation of an artery immediately distal to a partially occluding band, and its bearing on the dilatation of the subclavian artery observed in certain cases of cervical rib","volume":"24","author":"Halsted","year":"1916","journal-title":"J Exp Med"},{"key":"2024092809014315600_bib8","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1097\/00000658-192785060-00005","article-title":"Cervical rib. A method of anterior approach for relief of symptoms by division of the scalenus anticus","volume":"85","author":"Adson","year":"1927","journal-title":"Ann Surg"},{"key":"2024092809014315600_bib9","first-page":"101","volume-title":"Indications for Vascular Surgery","author":"Porter","year":"1988"},{"key":"2024092809014315600_bib10","first-page":"1077","article-title":"The place of scalenectomy and first-rib resection in thoracic outlet syndrome","volume":"92","author":"Roos","year":"1982","journal-title":"Surgery"},{"key":"2024092809014315600_bib11","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/00000658-197705000-00011","article-title":"Is rib resection necessary for relief of thoracic outlet syndrome?","volume":"185","author":"Stallworth","year":"1977","journal-title":"Ann Surg"},{"key":"2024092809014315600_bib12","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1097\/00000658-197505000-00010","article-title":"Management of the thoracic outlet syndrome","volume":"181","author":"Dale","year":"1975","journal-title":"Ann Surg"},{"key":"2024092809014315600_bib13","first-page":"434","article-title":"Reoperation for thoracic outlet syndrome","volume":"30","author":"Sessions","year":"1989","journal-title":"J Cardiovasc Surg"},{"key":"2024092809014315600_bib14","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1097\/00000658-197911000-00017","article-title":"Thoracic outlet syndrome: current concepts of treatment","volume":"190","author":"Kelly","year":"1979","journal-title":"Ann Surg"},{"key":"2024092809014315600_bib15","first-page":"109","article-title":"Scalenectomy versus first rib resection for treatment of thoracic outlet syndrome","volume":"85","author":"Sanders","year":"1979","journal-title":"Surgery"},{"key":"2024092809014315600_bib16","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0003-4975(10)64882-5","article-title":"Reoperation for recurrent thoracic outlet syndrome","volume":"21","author":"Urschel","year":"1976","journal-title":"Ann Thorac Surg"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800781015","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/78\/10\/1193\/59392954\/bjs1800781015.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/78\/10\/1193\/59392954\/bjs1800781015.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T09:01:50Z","timestamp":1727514110000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/78\/10\/1193\/6175120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,10,1]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[1991,10,1]]},"published-print":{"date-parts":[[1991,10,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800781015","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[1991,10]]},"published":{"date-parts":[[1991,10,1]]}}}