Fedyshin Peter A, Carey Michelle, Shaikh Shazad L, Klena James W
Department of Cardiovascular Surgery, Geisinger Community Medical Center, Scranton, PA, USA.
Department of Orthopedic Surgery, Geisinger Community Medical Center, Scranton, PA, USA.
Am J Case Rep. 2020 Mar 6;21:e920910. doi: 10.12659/AJCR.920910.
BACKGROUND Chest wall reconstruction is sometimes needed after resection of a thoracic malignancy. Various materials and techniques have been utilized to restore stability and integrity to the chest wall. We report what we believe is the first use of a cadaveric Achilles tendon to restore stability and function to the chest wall of a young woman who underwent chest wall resection and right upper lobectomy for a superior sulcus tumor. CASE REPORT A 46-year-old woman underwent resection of her first through fourth right ribs in addition to her right upper lobe for a squamous cell superior sulcus tumor. Because it was felt her right scapula provided sufficient coverage of her resultant chest wall defect, her chest wall was not reconstructed post-operatively. The patient experienced 2 episodes of scapular prolapse into her thoracic cavity several months after her resection. After the second episode, her right chest wall was successfully reconstructed with a cadaveric Achilles tendon to prevent further episodes of prolapse. CONCLUSIONS We believe this is the first description of chest wall reconstruction with a cadaveric Achilles tendon. The use of a cadaveric Achilles tendon should be considered for reconstruction of the chest wall after complex resection due to its strength characteristics, resistance to subsequent infection, and availability.
胸壁恶性肿瘤切除术后有时需要进行胸壁重建。已采用各种材料和技术来恢复胸壁的稳定性和完整性。我们报告了我们认为首次使用尸体跟腱来恢复一名年轻女性胸壁稳定性和功能的情况，该女性因肺上沟瘤接受了胸壁切除和右上叶切除。
一名46岁女性因鳞状细胞肺上沟瘤接受了右侧第一至第四肋骨及右上叶切除。由于认为其右肩胛骨为由此产生的胸壁缺损提供了足够的覆盖，术后未对其胸壁进行重建。患者在切除术后数月经历了2次肩胛骨脱垂至胸腔的情况。第二次发作后，用尸体跟腱成功重建了其右胸壁，以防止进一步的脱垂发作。
我们认为这是首次关于用尸体跟腱进行胸壁重建的描述。由于其强度特性、抗后续感染能力和可得性，在复杂切除术后的胸壁重建中应考虑使用尸体跟腱。
