Wu Xianning, Chen Mingjiu, Yu Fenglei
Department of Cardio-Thoracic Surgery, Second Xiangya Hospital, Central South University, Changsha Hunan 410008, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1224-6.
To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors.
Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patients were admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm x 3 cm to 10 cm x 8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm x 8 cm to 18 cm x 14 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect.
The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodeling. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during follow-up.
Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodeling, and less complication.
探讨钛板及聚四氟乙烯补片在胸骨肿瘤切除术后胸壁重建的方法及效果。
2006年10月至2009年11月,对4例胸骨肿瘤患者进行治疗并重建胸廓。其中男性2例,女性2例,年龄30 - 55岁。患者因胸部肿块或疼痛入院。可触及肿块大小为4 cm×3 cm至10 cm×8 cm。CT检查显示骨质破坏。胸骨肿瘤切除后,缺损大小为10 cm×8 cm至18 cm×14 cm,采用钛板及聚四氟乙烯补片修复重建胸壁缺损。
4例均成功实施肿瘤切除及胸壁缺损重建手术。切口一期愈合,无呼吸异常、皮下气肿、气胸及感染。1例术后6个月失访;1例死于颅内出血;2例分别随访1年和4年,无肿瘤复发。胸壁重塑良好。随访期间未观察到钛板松动、外露,无呼吸困难、胸部憋闷及胸痛。
胸骨肿瘤手术切除后会造成较大胸壁缺损,采用钛板及聚四氟乙烯补片修复具有操作简便、重塑满意、并发症少等优点。