Complications - Thoracic outlet syndrome (TOS) - Left transaxillary first rib resection (TFRR) - Vascular surgery

  1. Intraoperative complications

    Injury to the subclavian vein and artery

    • Compression, suture of the vessel
    • Injuries to the subclavian vein are difficult to control because the constricted space makes placement of vascular clamps nearly impossible (cell saver, occasional mass transfusion required)

    Plexus injury

    • e.g. intercostobrachial nerve; long thoracic nerve; dorsal scapular nerve; phrenic nerve
    • Iatrogenic sharp plexus injury -> neurosurgeon consult
    • if neurosurgeon unavailable: adaptive perineural suture with nonabsorbable monofilament stitches; leave tails long since this facilitates definitive treatment according to the deferred urgency protocol
Postoperative complications

Secondary bleedingDepending on the finding -> evacuate the hematoma and staunch the bleeding or

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