Morgan R F, Edgerton M T, Wanebo H J, Daniel T M, Spotnitz W D, Kron I L
Department of Plastic Surgery, University of Virginia Medical Center, Charlottesville 22908.
Ann Surg. 1988 Jun;207(6):707-16. doi: 10.1097/00000658-198806000-00010.
Over the last 5 years, 14 patients were treated by wide en bloc resection of chest wall tumors with primary reconstruction. There were nine females and five male patients with an age range of 31-77 years. All patients had a skeletal resection of the chest wall. An average of 3.9 ribs were resected in the patients treated. In three patients a partial sternectomy was carried out in conjunction with the rib resections. Chest wall skeletal defects were reconstructed with Prolene mesh, which was placed under tension. Soft tissue reconstruction utilized selected portions of the latissimus dorsi musculocutaneous territory with fasciocutaneous extensions beyond the muscle itself. Primary healing was obtained in all patients and secondary procedures were not required. The average hospitalization was 23 days. All patients survived the resection and reconstruction and were alive 30 days after operation. In selected patients the preservation of a portion of the innervated muscle in situ or the transfer of the muscle with the preservation of its resting length has maintained the majority of the muscle function.
在过去5年中，14例患者接受了胸壁肿瘤整块广泛切除并一期重建治疗。其中女性9例，男性5例，年龄范围为31至77岁。所有患者均进行了胸壁骨骼切除。接受治疗的患者平均切除3.9根肋骨。3例患者在肋骨切除的同时进行了部分胸骨切除术。胸壁骨骼缺损用置于张力下的普理灵补片进行重建。软组织重建利用背阔肌肌皮瓣的选定部分，并带有超出肌肉本身的筋膜皮瓣延伸。所有患者均实现一期愈合，无需二次手术。平均住院时间为23天。所有患者均在切除和重建后存活，术后30天仍存活。在部分患者中，原位保留一部分有神经支配的肌肉或转移肌肉并保留其静息长度，维持了大部分肌肉功能。
