Thoracic Surgey Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via G Venezian 1, 20133, Milano, Italy.
Updates Surg. 2023 Aug;75(5):1093-1102. doi: 10.1007/s13304-023-01562-z. Epub 2023 Jul 4.
The extension of chest wall resection for the treatment of primary and secondary tumours is still widely debated. The reconstructive strategy after extensive surgery is challenging as well as chest wall demolition itself. Reconstructive surgery aims to avoid respiratory failure and to guarantee intra-thoracic organs protection. The purpose of this review is to analyse the literature on this issue focusing on the planning strategy for chest wall reconstruction. This is a narrative review, reporting data from the most interesting studies on chest wall demolition and reconstruction. Representative surgical series on chest wall thoracic surgery were selected and described. We focused to identify the best reconstructive strategies analyzing employed materials, techniques of reconstruction, morbidity and mortality. Nowadays the new "bio-mimetic" materials in "rigid" and "non-rigid" chest wall systems reconstructive represent new horizons for the treatment of challenging thoracic diseases. Further prospective studies are warranted to identify new materials enhancing thoracic function after major thoracic excisions.
胸壁切除术治疗原发性和继发性肿瘤的范围仍存在广泛争议。广泛手术后的重建策略与胸壁破坏本身一样具有挑战性。重建手术旨在避免呼吸衰竭并保证胸腔内器官的保护。本文的目的是分析关于这个问题的文献，重点是胸壁重建的规划策略。这是一个叙述性综述，报告了有关胸壁破坏和重建的最有趣研究的数据。选择并描述了有代表性的胸壁胸外科手术系列。我们专注于通过分析使用的材料、重建技术、发病率和死亡率来确定最佳的重建策略。如今，新型“仿生”材料在“刚性”和“非刚性”胸壁系统重建中为治疗具有挑战性的胸科疾病开辟了新的前景。需要进一步的前瞻性研究来确定新的材料，以增强大型胸部切除术后的胸科功能。
