Vascular thoracic outlet compression syndrome

The aim of this study was to describe our experience with the surgical treatment of arterial and venous thoracic outlet syndrome. This prospective study included 25 patients with vascular compression at thoracic outlet area. They were admitted to Vascular Surgery Unit, Mansoura University Hospital during the period from July 2004 to July 2007. Patients were classified into two main groups. Group I [arterial thoracic outlet syndrome, n = 16]. Group II [venous thoracic outlet syndrome, n = 9]. The operations of arterial reconstruction were worthwhile for all patients with excellent results in 11 patients [84.6%], only 2 patients [15.4%] developed early postoperative thrombosis which was managed by transbrachial thrombectomy. The success rate of surgical interference for venous non-thrombotic patients was 100% while conservative treatment of thrombotic patients showed success in 4 patients [57%] and failure in 3 patients [43%]. In patients with vascular compression, resection of the first rib, resection of cervical rib, scalenectomy and neurolysis of the brachial plexus are recommended in addition to vascular reconstruction. Our experience using the supraclauicular approach indicate that this is a safe route with good results and minimal risk to the patients health

Early outcome and follow up on 25 cases with vascular compression at thoracic outlet area

The aim of this study is to describe our experience with the surgical treatment of arterial and venous thoracic outlet syndrome. This prospective study included 25 patients with vascular compression manifestations at thoracic outlet area. They were admitted to Vascular Surgery Unit, Mansoura University Hospital during the period from July 2004 to December 2007. patients were classified into two main groups. Group I [arterial thoracic outlet syndrome, n=16]. Group II [venous thoracic outlet syndrome, n=9]. The operations for arterial reconstruction [n=13] were worthwhile for all patients with excellent results in 11 patients [84.6%], only 2 patients [15.4%] developed early postoperative thrombosis which was managed by transbrachial thrombectomy. The success rate of surgical interference for nonthrombotic venous patients [n=2] was 100% while that for thrombotic venous patients showed success in 4 patients [57%] and failed in 3 patients [43%]. In patients with vascular compression, resection of the first rib, resection of cervical rib, scalenectomy and neurolysis of the brachial plexus are recommended in addition to vascular reconstruction. Our experiences using the supraclavicular approach indicate that this is a safe route with good results and minimal risk to the patients health

Peripheral vascular malformations: favorable outcome

In the period from May 1999 and January 2003, 45 patients were presented with arteriovenous malformations. All patients were subjected to thorough history taking, clinical examination and investigation with recent modalities techniques. A surgical excision was done in all cases; wide surgical excision of hemangioma and preliminary ligation of the feeding vessels was done in case of arteriovenous communication. Residual lesions were subjected to a further excision or injection sclerotherapy with ethanol. An excellent outcome was obtained in most of the patients, with only residual lesions in seven patients who were treated by a further excision or injection sclerotherapy with ethanol. There was no major complication in the postoperative period, e.g. DVT and PE. There was no recurrence in the study

Human leucocyte antigen [HLA] class one [A1, B7] and class two [DR-11] are new factors affecting the incidence of colonic carcinoma

The problem of colonic carcinoma is still a dilemma regarding, diagnostic and therapeutic strategy. Many factors have been found to affect the incidence of this type of cancer such as age, sex, diet and previous abdominal surgery. A survey study revealed that in normal [control] population HLA-A1 was positive in about 50%. HLA-B7 was positive in about 8% and HLA-DR11 was positive in about 40%. The aim of this study was to find a relation between the above-mentioned types of HLA and the increased or decreased risk of incidence of colonic carcinoma. Thirty patients were diagnosed after using: careful history taking, clinical examination, laboratory, and radiological investigations. Finally colonoscopy and biopsy were done. Detection of [HLA- A1. B7] was done serologically using Sigma USA. Detection of [HLA-DR 11] was done using lymphobeads method [Biotest Great Britain [UK] Itd]. HLA-A1 was found to be positive in eight patients while HLA-B7 was positive in seven patients, and HLA-DR 11 was positive in ten patients. HLA-A1 positive results were associated with increased risk of incidence of colonic carcinoma by 45%, while HLA-B7 positive results were associated with increased risk of incidence by 233% and presence of HLA-DR11 positive results were associated with decreased risk incidence by 80%. So we can consider the above-mentioned HLA types as new factors affecting the incidence of colonic carcinoma