<prompt> Which of the following is not a complication of surgery for thoracic outlet syndrome.PneumothoraxBrachial plexus injuryLymphocutaneous fistulaLong thoracic nerve injury  <response>: 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 procedureComplications of surgical tit of thoracic outlet syndrome Brachial plexus injuryInjury to long thoracic nerve leading to winging of the scapulaHomers syndromeVascular injuries subclavian artery , subclavian veinAir embolus as a result of subclavian vein injuryPneumothoraxThoracic Outlet Syndrome Thoracic 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 These neurovascular structures of the upper extremity may be compressed by a variety of structures, such asBone- cervical rib, abnormal first rib, long transverse process of C7, osteoarthritisMuscles- scalenusTrauma- neck hematoma, bone dislocation, clavicular fractureFibrous bands- congenital or acquiredNeoplasms- Pancoasts tumor emedicine.com writesThe 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.ManagementInitial method of management is nonsurgical.Physical and occupational therapy:improvements in a postural sitting, standing, and sleeping positions are recommended, along with behavior modification at work.muscle strengthening and stretching exercisessuperficial or deep heat therapy50 to 90 of patients can be treated with these nonsurgical measures.Surgeryresection of the first rib, accessory rib or fibrous band, scalenectomy 