Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Utrecht, Wilhelmina Children's Hospital and Princess Máxima Center, Utrecht, the Netherlands.
Department of Pediatric Surgery, Princess Máxima Center, Utrecht, the Netherlands.
Eur J Pediatr Surg. 2023 Dec;33(6):431-440. doi: 10.1055/a-2013-3074. Epub 2023 Jan 14.
An appropriate reconstruction strategy after surgical resection of chest wall tumors in children is important to optimize outcomes, but there is no consensus on the ideal approach. The aim of this study was to provide an up-to-date systematic review of the literature for different reconstruction strategies for chest wall defects in patients less than 18 years old. A systematic literature search of the complete available literature was performed and results were analyzed. A total of 22 articles were included in the analysis, which described a total of 130 chest wall reconstructions. All were retrospective analyses, including eight case reports. Reconstructive options were divided into primary closure ( = 21 [16.2%]), use of nonautologous materials ( = 83 [63.8%]), autologous tissue repair ( = 2 [1.5%]), or a combination of the latter two ( = 24 [18.5%]). Quality of evidence was poor, and the results mostly heterogeneous. Reconstruction of chest wall defects can be divided into four major categories, with each category including its own advantages and disadvantages. There is a need for higher quality evidence and guidelines, to be able to report uniformly on treatment outcomes and assess the appropriate reconstruction strategy.
儿童胸壁肿瘤切除术后，选择合适的重建策略对于优化治疗结果非常重要，但目前对于理想的治疗方法尚未达成共识。本研究旨在对 18 岁以下胸壁缺损患者的不同重建策略进行全面的系统回顾。对所有可用的文献进行了系统的文献检索，并对结果进行了分析。共纳入 22 篇文章，共描述了 130 例胸壁重建。均为回顾性分析，包括 8 例病例报告。重建方法分为直接缝合（21 例，占 16.2%）、非自体材料（83 例，占 63.8%）、自体组织修复（2 例，占 1.5%）或两者结合（24 例，占 18.5%）。证据质量较差，结果大多异质性较大。胸壁缺损的重建可分为四大类，每一类都有其自身的优缺点。需要高质量的证据和指南，以便能够统一报告治疗结果，并评估合适的重建策略。
