This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'Which of the following is not a complication of surgery for thoracic outlet syndrome. \nSelect and explain. \nA. Pneumothorax, B. Brachial plexus injury, C. Lymphocutaneous fistula, D. Long thoracic nerve injury', 'role': 'user'}, {'content': "Answer: C \nExplanation: Surgical treatment in thoracic outlet syndrome has been known to have devastating complications, especially brachial plexopathy (eg, injury to the long thoracic nerve with scapular winging). Conservative treatment appears to be the most universally accepted approach, with even surgeons recommending a prolonged trial before any operative procedure\nComplications of surgical tit of thoracic outlet syndrome \n\nBrachial plexus injury\nInjury to long thoracic nerve leading to winging of the scapula\nHomer's syndrome\nVascular injuries — subclavian artery , subclavian vein\nAir embolus as a result of subclavian vein injury\nPneumothorax\n\nThoracic Outlet Syndrome \n\nThoracic outlet syndrome ( TOS ) refers to compression of the subclavian vessels and nerves of the brachial plexus in the region of the thoracic inlet. ( note that even though the actual site of pathology is the thoracic inlet the condition is called thoracic outlet syndrome )\nThese neurovascular structures of the upper extremity may be compressed by a variety of structures, such as\nBone- cervical rib, abnormal first rib, long transverse process of C7, osteoarthritis\nMuscles- scalenus\nTrauma- neck hematoma, bone dislocation, clavicular fracture\nFibrous bands- congenital or acquired\nNeoplasms- Pancoast's tumor emedicine.com writes\n\n\nThe primary cause is believed to be mechanical or postural. Stress, depression, overuse, and habit all can lead to the forward head, droopy shoulder, and collapsed chest posture that allows the thoracic outlet to narrow and compress the neurovascular structures. Accessory ribs or fibrous bands when present, predispose the site to narrow and compression.\n\nManagement\n\nInitial method of management is nonsurgical.\n\nPhysical and occupational therapy:\n\nimprovements in a postural sitting, standing, and sleeping positions are recommended, along with behavior modification at work.\nmuscle strengthening and stretching exercises\nsuperficial or deep heat therapy\n50 to 90% of patients can be treated with these nonsurgical measures.\n\n\nSurgery\n\nresection of the first rib, accessory rib or fibrous band, scalenectomy", 'role': 'assistant'}]