Yoon Dong Woog, Kim Tae Ho, Cha Min Jae, Kim Gun-Hee, Lee ByoungSoo, Kim Hyung Giun, Kwon Minhyeok, Jang Donghoon, Park Byungjoon
Department of Thoracic and Cardiovascular Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Interdiscip Cardiovasc Thorac Surg. 2024 Mar 29;38(4). doi: 10.1093/icvts/ivae037.
Chest wall reconstruction is challenging due to the complex shape and large defect size. The three-dimensional printing technology enables the fabrication of customized implants, and 3D-printed pure-titanium could provide superior mechanical properties to conventional materials. The aim of this study was to evaluate long-term outcomes of patients undergoing chest wall reconstruction with a 3D-printed pure-titanium implant. Between August 2018 and May 2021, 5 patients underwent surgery due to sternal metastasis (n = 3), postoperative sternal wound infection (n = 1) and deformity (n = 1). The customized implant was designed and constructed based on the size and shape of the chest wall defect measured on computed tomography. All patients demonstrated uneventful recovery without complications during the hospital course. During the median follow-up of 20 months, 1 patient underwent revision surgery due to implant breakage, and 1 removed the implant due to trauma-related chest wall infection. One patient died from cancer progression, while 3 patients are alive without any implant-related complications. Chest wall reconstruction using a 3D-printed pure-titanium implant could be a novel alternative for patients with various conditions affecting the sternum and ribs.
由于胸壁形状复杂且缺损尺寸较大,胸壁重建具有挑战性。三维打印技术能够制造定制植入物,并且3D打印的纯钛材料相较于传统材料可提供更优异的机械性能。本研究的目的是评估接受3D打印纯钛植入物进行胸壁重建患者的长期预后。在2018年8月至2021年5月期间,5例患者因胸骨转移(n = 3)、术后胸骨伤口感染(n = 1)和畸形(n = 1)接受了手术。根据计算机断层扫描测量的胸壁缺损大小和形状设计并构建定制植入物。所有患者在住院期间恢复顺利,无并发症发生。在中位随访20个月期间,1例患者因植入物断裂接受了翻修手术,1例因创伤相关的胸壁感染取出了植入物。1例患者死于癌症进展,3例患者存活,无任何与植入物相关的并发症。使用3D打印纯钛植入物进行胸壁重建可能是患有影响胸骨和肋骨各种病症患者的一种新选择。