Hong-sheng Liu, Ying-zhi Qin, Shan-qing Li, Li Li, Yu-shang Cui, Zhi-yong Zhang
Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese.
Chin Med Sci J. 2011 Dec;26(4):237-40. doi: 10.1016/s1001-9294(12)60007-8.
To evaluate the use of titanium mesh reconstruction after sternal tumor resection.
From January 2007 to January 2011, 14 patients with sternal tumors were admitted into Peking Union Medical Hospital. The clinical characteristics, surgical resection, and technique of reconstruction were reviewed.
Of the 14 patients, 3 had a metastatic sternal tumor, the primary sites of which were as follows: hepatic carcinoma in one case (metastasis 19 years after operation), breast carcinoma in another case (metastasis 5 years after operation), and renal carcinoma in the other case (found simultaneously). Two patients showed local involvement of the sternum: 1 had thymic carcinoma, and the other had myofibrosarcoma. The remaining 9 patients had primary tumors: 4 were osteochondroma, 3 chondrosarcoma, 1 eosinophilic granuloma, 1 non-Hodgekin's lymphoma. En bloc resection of the sternal tumor was performed in all the 14 patients. The defect was repaired with the titanium mesh adjusted to the shape of the defect and fixed with the stainless steel wire. Eleven patients were followed up for a period from 2 months to 4 years, during which no translocation or broken of the titanium mesh was observed.
Radical en bloc excision remains the treatment of choice for sternal tumors. Sternum defect reconstruction using titanium mesh as a rigid replacement proves appropriate and effective.
评估胸骨肿瘤切除术后钛网重建的应用。
2007年1月至2011年1月,14例胸骨肿瘤患者入住北京协和医院。回顾其临床特征、手术切除及重建技术。
14例患者中,3例为胸骨转移瘤,原发部位如下:1例为肝癌(术后19年转移),1例为乳腺癌(术后5年转移),另1例为肾癌(同时发现)。2例患者显示胸骨局部受累:1例为胸腺癌,另1例为肌纤维肉瘤。其余9例患者为原发性肿瘤:4例为骨软骨瘤,3例为软骨肉瘤,1例为嗜酸性肉芽肿,1例为非霍奇金淋巴瘤。14例患者均行胸骨肿瘤整块切除。用根据缺损形状调整的钛网修复缺损,并用不锈钢丝固定。11例患者随访2个月至4年,期间未观察到钛网移位或断裂。
整块根治性切除仍是胸骨肿瘤的首选治疗方法。使用钛网作为刚性替代物进行胸骨缺损重建被证明是合适且有效的。