Smelt Jeremy, Pontiki Antonia, Jahangiri Marjan, Rhode Kawal, Nair Arjun, Bille Andrea
Department of Thoracic Surgery, Guy's and Saint Thomas' NHS Foundation Trust, London, London, United Kingdom of Great Britain and Northern Ireland.
King's College London School of Medical Education, London, London, United Kingdom of Great Britain and Northern Ireland.
Thorac Cardiovasc Surg. 2020 Jun;68(4):352-356. doi: 10.1055/s-0039-1678611. Epub 2019 Feb 8.
Patients undergoing surgery for locally advanced lung cancer involving the chest wall require anatomical lung with extensive en-bloc chest wall resection and appropriate reconstruction.In this proof-of-concept study, we aimed to produce personalized three-dimensional (3D)-printed chest wall prosthesis for a patient undergoing chest wall resection and reconstruction using clinically obtained computed tomography (CT) data.
Preoperative CT scans of three patients undergoing chest wall resection were analyzed and the areas of resection segmented. This was then used to produce a 3D print of the chest wall and a silicone mold was created from the model. This mold was sterilized and used to produce methyl methacrylate prostheses which were then implanted into the patients.
Three patients had their chest wall reconstructed using this technique to produce a patient specific prosthesis. There were no early complications or deaths.
It is possible to use 3D printing to produce a patient specific chest wall reconstruction for patients undergoing chest wall resection for malignancy that is cost-effective. This chest wall is thought to provide stability in the form of prosthetic ribs as well compliance in the form of an expanded polytetrafluoroethylene patch. Further research is required to measure chest wall compliance during the respiratory cycle and long-term follow-up from this method.
对于因局部晚期肺癌累及胸壁而接受手术的患者，需要进行广泛整块胸壁切除及适当重建的解剖性肺切除。在这项概念验证研究中，我们旨在利用临床获取的计算机断层扫描（CT）数据，为一名接受胸壁切除及重建的患者制作个性化三维（3D）打印胸壁假体。
分析了三名接受胸壁切除患者的术前CT扫描，并对切除区域进行分割。然后用此数据制作胸壁的3D打印模型，并根据该模型制作硅胶模具。对该模具进行消毒后，用于制作甲基丙烯酸甲酯假体，随后将假体植入患者体内。
三名患者采用该技术进行胸壁重建，制作出了患者特异性假体。无早期并发症或死亡病例。
利用3D打印为因恶性肿瘤接受胸壁切除的患者制作患者特异性胸壁重建假体是可行的，且具有成本效益。这种胸壁被认为能以假体肋骨的形式提供稳定性，并以膨体聚四氟乙烯补片的形式提供顺应性。需要进一步研究来测量呼吸周期中的胸壁顺应性以及该方法的长期随访情况。
