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可吸收肋骨替代品行胸廓成形术的临床经验。

Clinical experience of thoracoplasty with absorbable rib substitutes.

机构信息

Pediatric Surgical Oncology Department, Hospital Militar Central, Transversal 3° No. 49 - 00, Piso 8, 110231, Bogotá, Colombia.

Pediatric Surgery Department, Universidad Militar Nueva Granada, Bogotá, Colombia.

出版信息

Pediatr Surg Int. 2023 Mar 4;39(1):146. doi: 10.1007/s00383-023-05413-1.

Abstract

PURPOSE

Malignant chest wall tumors are rare in pediatrics. They require multimodal oncological treatment and local surgical control. Resections are extensive; therefore, thoracoplasty should be planned to protect intrathoracic organs, prevent herniation, future deformities, preserve ventilatory dynamics, and enable radiotherapy.

METHODS

We present a case series of children with malignant chest wall tumors and our surgical experience with thoracoplasty using absorbable rib substitutes (BioBridge), after local surgical control. BioBridge is a copolymer made of a polylactide acid blend (70% L-lactic acid y 30% DL-lactide).

RESULTS

In 2 years, we had three patients with malignant chest wall tumors. Resection margins were negative, without recurrence at follow-up. We achieved good cosmetic and functional results, and no postoperative complications.

CONCLUSION

Alternative reconstruction techniques such as absorbable rib substitutes provide protection, guarantee a flexible chest wall, and do not interfere with adjuvant radiotherapy. Currently, there are no management protocols in thoracoplasty. This option represents an excellent alternative for patients with chest wall tumors. Knowledge of different approaches and reconstructive principles is essential to offer children the best onco-surgical option.

摘要

目的

儿童恶性胸壁肿瘤较为罕见。此类肿瘤需要多模式肿瘤治疗和局部手术控制。由于切除范围广泛,因此应计划行胸廓成形术以保护胸内器官、防止疝出、避免未来畸形、保持通气动力学并能够进行放疗。

方法

我们报告了一组儿童恶性胸壁肿瘤病例,并介绍了使用可吸收肋骨替代品(BioBridge)进行局部手术控制后的胸廓成形术的手术经验。BioBridge 是一种由聚乳酸共混物(70% L-乳酸和 30% DL-乳酸)制成的共聚物。

结果

在 2 年期间,我们有 3 例恶性胸壁肿瘤患者。切缘均为阴性,随访期间无复发。我们获得了良好的美容和功能效果,且无术后并发症。

结论

替代重建技术,如可吸收肋骨替代品,可提供保护、保证灵活的胸壁且不干扰辅助放疗。目前,尚无胸廓成形术的管理方案。对于胸壁肿瘤患者来说,这是一种很好的选择。了解不同的方法和重建原则至关重要,可为儿童提供最佳的肿瘤外科治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed3d/9985550/6638d60428af/383_2023_5413_Fig1_HTML.jpg

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