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南美地区胸部肿瘤术后胸壁重建相关并发症的经验。

A South American Experience With Postoperative Complications Following Chest Wall Reconstruction for Neoplasms.

机构信息

Thoracic Surgery Department, Instituto Nacional de Cancerología, Calle 1 No. 9-85, Bogotá, 111511, Colombia.

Surgical Oncology Department, Instituto Nacional de Cancerología, Calle 1 No. 9-85, Bogotá, 111511, Colombia.

出版信息

World J Surg. 2021 Oct;45(10):2982-2992. doi: 10.1007/s00268-021-06215-z. Epub 2021 Jun 27.

Abstract

BACKGROUND

This study aims to report postoperative complications of chest wall reconstructions due to resections of primary or secondary neoplasms in a South American cancer institution and their association with prosthesis reconstruction.

MATERIALS AND METHODS

We retrospectively reviewed clinical records of patients with primary or secondary chest wall neoplasms who underwent resection and reconstruction between November 2008 and October 2018 at the Instituto Nacional de Cancerología, Bogota, Colombia.

RESULTS

A total of 77 patients were analyzed, 50 were women (64.9%), and the median age was 45.8 years. There were 22(28.6%) sternal resections and 55(71.4%) costal resections. Prosthetic material was used in 14(18.2%) sternal and 37(48.1%) costal reconstructions. There were 26(33.7%) early postoperative complications and 16(20.8%) reinterventions. Infections were observed in 12(15.6%) patients and 4(5.2%) patients developed respiratory complications. 33.3% of all the early infections were presented in patients with methyl methacrylate (MMA) reconstructions and the same percentage in those with titanium plates. There were six (7.8%) late complications and five were related to prosthetic material extrusion, all required prosthetic material removal. The mean overall survival was 77,3 months (SD = 8 months), and 1-year and 5-year overall survival was 85% and 61%, respectively.

CONCLUSIONS

Infections were the more frequent postoperative complications in chest wall reconstructions. The use of either MMA or titanium plates was not related to early postoperative complications, although MMA reconstructions developed higher late complications and required prosthetic material removal.

摘要

背景

本研究旨在报告一家南美癌症机构因原发性或继发性肿瘤切除后进行的胸壁重建的术后并发症及其与假体重建的关系。

材料和方法

我们回顾性分析了 2008 年 11 月至 2018 年 10 月期间在哥伦比亚波哥大国家癌症研究所接受原发性或继发性胸壁肿瘤切除和重建的患者的临床记录。

结果

共分析了 77 例患者,其中 50 例为女性(64.9%),中位年龄为 45.8 岁。有 22 例(28.6%)胸骨切除术和 55 例(71.4%)肋骨切除术。14 例(18.2%)胸骨和 37 例(48.1%)肋骨重建采用了假体材料。有 26 例(33.7%)出现早期术后并发症和 16 例(20.8%)再次干预。12 例(15.6%)患者发生感染,4 例(5.2%)患者发生呼吸并发症。所有早期感染中有 33.3%发生在使用甲基丙烯酸甲酯(MMA)重建的患者中,有同样百分比的患者发生在使用钛板的患者中。有 6 例(7.8%)出现晚期并发症,其中 5 例与假体材料脱出有关,均需取出假体材料。总的平均生存时间为 77.3 个月(标准差=8 个月),1 年和 5 年的总生存率分别为 85%和 61%。

结论

胸壁重建术后感染是最常见的并发症。使用 MMA 或钛板与早期术后并发症无关,尽管 MMA 重建后出现较高的晚期并发症,并需要取出假体材料。

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