Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
Ann Thorac Surg. 2019 Mar;107(3):921-928. doi: 10.1016/j.athoracsur.2018.09.044. Epub 2018 Nov 4.
The purpose of this study is to use 3-dimensional printing (3DP) polyetheretherketone (PEEK) implants for skeletal reconstructions after wide excision of chest wall. 3DP PEEK implants were expected to provide a better physiological simulation than traditional ones because of a closer elastic modulus to cortical bone and similar biomechanical properties.
Eighteen patients (mean age 44.5 years), comprising 6 males and 12 females, underwent adequate radical wide excision for tumors and chest wall reconstruction using 3DP PEEK implants. Surgical data, which include patient demographic characteristics, implant preparation parameters, and preoperative and postoperative pulmonary function test results, were collected and analyzed.
Ten patients with rib tumors and 8 patients with sternum tumors were selected for the study. The mean chest wall defect size was 173.6 ± 151.5 cm (range, 55 to 625 cm). The mean weight of a single 3DP PEEK rib and sternum was 28 g and 104 g, respectively. The flexural and tensile strength of PEEK implants were 141 ± 7 MPa and 89 ± 3 MPa, respectively. Preoperative and postoperative pulmonary function tests revealed that mean forced vital capacity was from 2.79 ± 0.68 L to 2.40 ± 0.70 L with a reduction of 14.0% (p < 0.001). No side effects were observed 6 to 12 months after the operation.
These findings suggest that 3DP PEEK implant is a safe and effective alternative in the reconstruction of chest wall defects. The pulmonary function of the patient may be preserved effectively after surgery.
本研究旨在使用 3 维打印(3DP)聚醚醚酮(PEEK)植入物进行胸壁广泛切除后的骨骼重建。3DP PEEK 植入物有望提供比传统植入物更好的生理模拟,因为其弹性模量更接近皮质骨,生物力学特性也更相似。
18 例患者(平均年龄 44.5 岁),包括 6 例男性和 12 例女性,因肿瘤进行了充分的根治性广泛切除,并使用 3DP PEEK 植入物进行了胸壁重建。收集并分析了手术数据,包括患者的人口统计学特征、植入物准备参数以及术前和术后肺功能测试结果。
10 例肋骨肿瘤患者和 8 例胸骨肿瘤患者入选本研究。胸壁缺损平均大小为 173.6±151.5cm(范围 55-625cm)。单个 3DP PEEK 肋骨和胸骨的平均重量分别为 28g 和 104g。PEEK 植入物的弯曲和拉伸强度分别为 141±7MPa 和 89±3MPa。术前和术后肺功能测试显示,用力肺活量平均从 2.79±0.68L 降至 2.40±0.70L,减少了 14.0%(p<0.001)。术后 6-12 个月未见不良反应。
这些发现表明,3DP PEEK 植入物是胸壁缺损重建的一种安全有效的替代方法。手术后患者的肺功能可能得到有效保留。