<prompt> All of the following may be acceptable operative approaches to management of the thoracic outlet syndrome except:ScalenectomyExcision of a cervical ribThoracoplastyFirst rib resection  <response>: Supraclavicular decompression of the thoracic outlet is the preferred operative approach for the thoracic outlet syndrome. This procedure consists of extensive anterior scalenectomy, middle scalenectomy, removal of a cervical rib if present, and, on occasion, first rib resection. Transaxillary first rib resection has been widely used as well but is associated with a greater risk for complications. 