Fernandez Rafael A S, Lau Rainbow W H, Yu Peter S Y, Siu Ivan C H, Chan Joyce W Y, Ng Calvin S H
Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
AME Case Rep. 2020 Apr 30;4:12. doi: 10.21037/acr.2020.03.08. eCollection 2020.
A 44-year-old lady with solitary 4.4-cm metastasis to the manubrium from a previously resected invasive ductal carcinoma of the left breast underwent manubrio-sternal resection. We describe our unique approach of using 3-dimensional (3D)-computed tomography (CT) image segmentation planning for reconstructing desirable resection boundaries, design of ideal superficial and deep surgical resection guides, and followed by 3D printing of guides using autoclavable thermoplastic for use during surgery. The surgical guides over the ribs and sternum rapidly and accurately define resection lines intraoperatively, achieve good surgical margins, and could reduce resection and reconstruction related morbidity for performing complex surgical resection of the chest wall. The patient was discharged 2 weeks postoperatively and remained free from local recurrence on CT scan 1-year after resection.
一名44岁女性，既往有左乳浸润性导管癌切除术史，现出现胸骨柄孤立性4.4厘米转移灶，接受了胸骨柄切除术。我们描述了一种独特的方法，即使用三维（3D）计算机断层扫描（CT）图像分割规划来重建理想的切除边界，设计理想的浅表和深部手术切除导向器，然后使用可高压灭菌的热塑性塑料进行导向器的3D打印，以便在手术中使用。肋骨和胸骨上的手术导向器可在术中快速准确地确定切除线，实现良好的手术切缘，并可降低胸壁复杂手术切除的切除和重建相关发病率。患者术后2周出院，切除术后1年的CT扫描显示无局部复发。
