Wang Wenzhang, Yang Shiyan, Han Menghu, Liu Haifeng, Feng Qing, Su Yonglin, Han Yi, Wang Jin
Yanda Hospital, Hebei Medical University, Hebei, China.
Beijing AK Medical Co. Ltd, Beijing, China.
J Cardiothorac Surg. 2024 Oct 1;19(1):579. doi: 10.1186/s13019-024-03078-y.
Resection of thoracic wall tumors results in significant defects in the chest wall, leading to various complications. In recent years, the use of three-dimensional (3D) printed titanium alloy prostheses in clinical practice has demonstrated enhanced outcomes in chest wall reconstruction surgery. A cohort of seven patients with sternal tumors was identified for this study. Following a helical CT scan, a digital model was generated for the design of the prosthesis. Subsequently, the tumors were then removed together with the affected sternum and ribs. The chest wall was then reconstructed using 3D-printed titanium alloy prosthesis for bone reconstruction, mesh for pleural reconstruction, and flap for soft tissue reconstruction. Patients were monitored for a period of one year post-surgery. In the seven cases examined, the tumors were found in various locations with varying degrees of invasion. Based on the scope of surgical resection and the size of the defect, 3D-printed titanium alloy prosthesis was custom-designed for chest wall reconstruction. Prior to bone reconstruction, pleural reconstruction was achieved with Bard Composix E/X Mesh, while soft tissue repair involved muscle flap and musculocutaneous flap procedures. A one-year follow-up assessment revealed that the utilization of the 3D-printed titanium alloy prosthesis led to secure fixation, favorable histocompatibility, and enhanced lung function. The findings demonstrate that the utilization of 3D printed titanium alloy prostheses represents a significant advancement in the field of chest wall reconstruction and thoracic surgical procedures.
胸壁肿瘤切除术会导致胸壁出现严重缺损,进而引发各种并发症。近年来,三维(3D)打印钛合金假体在临床实践中的应用已证明在胸壁重建手术中能取得更好的效果。本研究纳入了7例胸骨肿瘤患者。在进行螺旋CT扫描后,生成了用于假体设计的数字模型。随后,将肿瘤连同受影响的胸骨和肋骨一并切除。然后使用3D打印钛合金假体进行骨重建、用网片进行胸膜重建以及用皮瓣进行软组织重建来重建胸壁。术后对患者进行了为期一年的监测。在所检查的7例病例中,肿瘤位于不同位置且侵袭程度各异。根据手术切除范围和缺损大小,定制设计3D打印钛合金假体用于胸壁重建。在进行骨重建之前,先用巴德Composix E/X网片进行胸膜重建,而软组织修复则采用肌皮瓣和肌肉皮瓣手术。一年的随访评估显示,使用3D打印钛合金假体实现了牢固固定、良好的组织相容性并改善了肺功能。研究结果表明,3D打印钛合金假体的应用代表了胸壁重建和胸外科手术领域的一项重大进展。