Appel Meret, Pradella Maurice, Djakovic Zeljko, Lardinois Didier
Department of Thoracic Surgery, University Hospital Basel and University Basel, Basel, Switzerland.
Surgical Outcome Research Center, University Hospital Basel, University of Basel, Basel, Switzerland.
J Thorac Dis. 2025 Jun 30;17(6):3981-3990. doi: 10.21037/jtd-2024-1983. Epub 2025 Jun 23.
For various reasons, a chest wall resection may be necessary. Large defects in the chest wall and sternum require reconstruction to avoid paradoxical, inadequate breathing, protect underlying structures, and achieve a good functional result. CodubixRibs is a prosthesis made of polyester and polypropylene yarn, which has been recently introduced for reconstruction. Our objective was to evaluate the integrity of the chest wall and the occurrence of pain in patients who underwent resection of the chest wall and/or sternum followed by reconstruction with CodubixRibs.
We postoperatively collected data from eleven patients (mean age 53 years) who underwent chest wall reconstruction with CodubixRibs between 2019 and 2023. At a prospective visit, pain was assessed using the numeric rating scale (NRS). Functionality was measured by assessing upper extremity mobility (QuickDASH questionnaire; 0 being the best, 100 the worst), clinical examination, and by time resolved dynamic (cine) magnetic resonance imaging (MRI).
Indications for resection were tumors (n=9) and osteomyelitis (n=2) in anterior (n=2), anterolateral (n=7), lateral (n=1), and posterolateral (n=1) locations. The sternum was involved in three patients. Complications included one patient with dislocation due to an initially undersized prosthesis, which was followed by an uneventful reoperation. Functional assessment was performed on nine patients at a median follow-up time of 11 (5.75, 49.5) months. The mean NRS pain score was 1.7±2.2, and the median QuickDASH score was of 6.8. The chest wall was stable in all patients. Dynamic MRI showed symmetric chest wall movement in all but two patients, without observation of paradoxical motion.
We observed excellent functional results using CodubixRibs for chest wall reconstruction, indicating high stability and low complication rates. However, further studies involving a greater number of patients are required to confirm our initial findings.
由于各种原因，可能需要进行胸壁切除术。胸壁和胸骨的大缺损需要重建，以避免反常呼吸、呼吸不足，保护深层结构，并取得良好的功能效果。CodubixRibs是一种由聚酯和聚丙烯纱线制成的假体，最近已被引入用于重建。我们的目的是评估接受胸壁和/或胸骨切除并随后用CodubixRibs重建的患者的胸壁完整性和疼痛发生率。
我们术后收集了2019年至2023年间11例（平均年龄53岁）接受CodubixRibs胸壁重建患者的数据。在一次前瞻性随访中，使用数字评分量表（NRS）评估疼痛。通过评估上肢活动度（QuickDASH问卷；0为最佳，100为最差）、临床检查以及通过时间分辨动态（电影）磁共振成像（MRI）来测量功能。
切除指征为肿瘤（n = 9）和骨髓炎（n = 2），位于前侧（n = 2）、前外侧（n = 7）、外侧（n = 1）和后外侧（n = 1）部位。三名患者的胸骨受累。并发症包括一名患者因最初假体尺寸过小而脱位，随后进行了顺利的再次手术。对9例患者进行了功能评估，中位随访时间为11（[5.75, 49.5]）个月。NRS疼痛评分平均为1.7±2.2，QuickDASH评分中位数为6.8。所有患者的胸壁均稳定。动态MRI显示，除两名患者外，所有患者的胸壁运动均对称，未观察到反常运动。
我们观察到使用CodubixRibs进行胸壁重建具有出色的功能效果，表明稳定性高且并发症发生率低。然而，需要进一步开展涉及更多患者的研究来证实我们的初步发现。
