Tan Zhenbo, Nirmal Lamichhane, Liu Dengxiang
Department of Thoracic Surgery, Xingtai People's Hospital, Xingtai Hebei, 054031, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2005 May;19(5):338-40.
To evaluate the results of chest wall reconstruction (CWR) in patients who underwent chest wall tumor resection accompanying huge chest wall defect.
From Jan. 1998 to Mar. 2003, 31 patients underwent CWR. Among them, 20 were male and 11 female. The age ranged from 8 to 72 years. The indications for resection were primary chest wall tumor in 21 patients, lung cancer with invasion of chest wall 6, recurrence of breast cancer 2, radiation necrosis 1 and skin cancer 1. The number of rib resected was 2-7 ribs (3.6 in average). The defect was 20-220 cm2 (97.1 cm2 in average). Concomitant resection was done in 13 patients, including lobectomy or wedge resection of lung 10, partial resection of diaphragm 2, and partial sternotomy 1. Seven patients underwent soft tissue reconstruction alone (latissimus dorsi+greater omentum, latissimus dorsi myocutaneous flap, latissimus dorsi muscle flap), 5 patients bony reconstruction alone (Prolene web), and simultaneous BR and STR were performed in 19 patients (latissimus dorsi, pectoralis major, latissimus dorsi+fascia lata, and Prolene web).
Three patients (9.7%) developed postoperative complications. Postoperative survival period was 6-57 months with a median of 22 months.
A favorable clinical outcome can be achieved by CWR for the patients with huge chest wall defects that result from resection of chest wall tumors.
评估接受胸壁肿瘤切除并伴有巨大胸壁缺损患者的胸壁重建(CWR)结果。
1998年1月至2003年3月,31例患者接受了胸壁重建。其中,男性20例,女性11例。年龄范围为8至72岁。切除指征为原发性胸壁肿瘤21例,肺癌侵犯胸壁6例,乳腺癌复发2例,放射性坏死1例,皮肤癌1例。切除肋骨数量为2至7根(平均3.6根)。缺损面积为20至220平方厘米(平均97.1平方厘米)。13例患者进行了联合切除,包括肺叶切除术或肺楔形切除术10例,部分膈肌切除术2例,部分胸骨切开术1例。7例患者仅进行软组织重建(背阔肌+大网膜、背阔肌肌皮瓣、背阔肌肌瓣),5例患者仅进行骨性重建(普理灵网片),19例患者同时进行骨性重建和软组织重建(背阔肌、胸大肌、背阔肌+阔筋膜、普理灵网片)。
3例患者(9.7%)出现术后并发症。术后生存期为6至57个月,中位生存期为22个月。
对于因胸壁肿瘤切除导致巨大胸壁缺损的患者,胸壁重建可取得良好的临床效果。