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胸骨切除术和新型模块化假体重建。

Sternal Resection and Reconstruction With a Novel Modularized Prosthesis.

机构信息

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China; Department of Surgery, Washington University School of Medicine, St Louis, Missouri.

出版信息

Ann Thorac Surg. 2020 Oct;110(4):1412-1416. doi: 10.1016/j.athoracsur.2020.05.048. Epub 2020 Jun 29.

Abstract

PURPOSE

Currently available techniques and materials for sternal reconstruction are limited in their clinical applicability. We aimed to design a durable prosthetic kit that can be tailored to each patient's sternal anatomy and function intraoperatively.

DESCRIPTION

A modularized sternal reconstruction system was designed, containing standardized components of different types and sizes, made of titanium alloy. This technology was applied to patients undergoing sternal resection and reconstruction.

EVALUATION

The system was employed in 7 patients undergoing sternal resection and reconstruction for local malignancy. Appropriate modules were chosen and integrated at the time of operation. The sternal prostheses were well integrated into the chest wall, without local infection, effusion, or instability. One patient died of recurrence 4 months after surgery. The remaining 6 patients recovered well, without local recurrence or prosthesis failure.

CONCLUSIONS

The most prominent advantage of this system is that there is no need for individualized design and manufacture before surgery. Therefore, this modularized system is potentially widely applicable as an adaptable and effective prosthesis for sternal reconstruction.

摘要

目的

目前用于胸骨重建的技术和材料在临床应用上存在局限性。我们旨在设计一种耐用的假体套件,可在术中根据每个患者的胸骨解剖结构和功能进行定制。

描述

设计了一种模块化的胸骨重建系统,包含不同类型和尺寸的标准化组件,由钛合金制成。该技术应用于接受胸骨切除和重建的患者。

评估

该系统在 7 名因局部恶性肿瘤而行胸骨切除和重建的患者中使用。在手术时选择并整合了合适的模块。胸骨假体与胸壁很好地融合,没有局部感染、渗液或不稳定。1 例患者术后 4 个月死于复发。其余 6 例患者恢复良好,无局部复发或假体失败。

结论

该系统最显著的优点是术前无需进行个体化设计和制造。因此,这种模块化系统作为一种适应性强且有效的胸骨重建假体具有广泛的应用潜力。

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