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Doctor, what is your “success rate” for TOS surgery? What hospitals consider a “success” will shock you. Its not “pain free”

You are obviously concerned about whether your surgery for thoracic outlet syndrome will be a success. The nurse sees this and says “Don’t worry because our doctors have 90% “success” for thoracic outlet syndrome surgery. You are received. To you, a success may be “pain free”. Thats not what the doctors authoring the research determine “success”.

Not so…

One study reported the results of surgery for thoracic outlet syndrome on 254 patients with neurogenic thoracic outlet syndrome (N-TOS). The follow-up post surgery analysis initially reported an 86.6% “success rate” after 2 months. You should be relieved and confident.

However after 18 months the success rate fell to 46.9% and after 72 months ended up at 36%. (1)

Eighty of those whos first surgery was a failure were recommended a second surgery to see if that would improve their suffering. After a second surgery only 45 of the 80 patients said they had results that were considered a “success”. (1)

The researchers considered a 50% improvement to be a success. (1) Would you consider a 50% improvement a success? Also this study determined after 72 months, 64% of the patients that had the surgery did not improve by 50%.

One study determined 90% of their surgeries were a success. (2)

The way they determined success was by asking their patients to fill out a questioner which asked them to grade their perception of pain relief. The procedure was considered a success if the patient reported an excellent, good or fair result. (3)

This could range from 66.7% reporting excellent to good results which meant either complete relief of symptoms to relief of most major symptoms. Those patients who reported to a relief of some symptoms but persistence (no relief) of other symptoms were 22%. (2)

Based on what the hospital determines is a “success” is for surgery they determined the surgeries were 90% successful. (2)

Would you consider a relief of some symptoms but persistence (no relief) of other symptoms to be a success?

So if you are walking back to see the surgeon and the nurse says, “Don’t worry, our doctors have a 90% success rate for surgery for thoracic outlet surgery you might want to ask them by what criterion they determined a successful surgery.

This is an excerpt from a chapter in Dr Stoxen’s #1 best seller The Human Spring Approach to Thoracic Outlet Syndrome. The book is available on Amazon.com in these 13 counties US UK DE FR ES IT NL JP BR CA MX AU IN on Kindle. The book is available on Amazon.com in these 7 counties US UK DE FR ES IT JP in paperback.

 

The Human Spring Approach to Thoracic Outlet Syndrome

Thank you for the opportunity to serve

(1) Altobelli GG1, Kudo T, Haas BT, Chandra FA, Moy JL, Ahn SS. Thoracic outlet syndrome: pattern of clinical success after operative decompression. J Vasc Surg. 2005 Jul;42(1):122-8. https://www.ncbi.nlm.nih.gov/pubmed/16012461

(2) Bhattacharya V1, Hansrani M, Wyatt MG, Lambert D, Jones NA. Outcome following surgery for thoracic outlet syndrome. Eur J Vasc Endovasc Surg. 2003 Aug;26(2):170-5. https://www.ncbi.nlm.nih.gov/pubmed/12917833 FREE PDF: http://www.ejves.com/article/S1078-5884(02)91891-5/pdf

(3) Sanders RJ1, Pearce WH. The treatment of thoracic outlet syndrome: a comparison of different operations. J Vasc Surg. 1989 Dec;10(6):626-34. https://www.ncbi.nlm.nih.gov/pubmed/2585651

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