de la Rocha A G, Robertson G A, Grafton R, Levitt M
Can J Surg. 1984 Nov;27(6):599-601.
A large metastatic squamous carcinoma of the anterior chest wall was managed by en-bloc resection of the thoracic wall. The extensive defect resulting from the resection was bridged with Marlex mesh superimposed on an omental flap that served as recipient to partial-thickness skin grafts. This composite reconstruction restored an efficient bellows action to the chest cage, manifested by the lack of anterior flailing and postoperative spirometry values, measured at the bedside, that were 75% of those obtained preoperatively. During the initial postoperative period, however, mechanical ventilatory assistance was required to treat an adult respiratory distress syndrome that together with mild anterior flailing made early extubation impossible.
一例前胸壁巨大转移性鳞状细胞癌通过胸壁整块切除进行治疗。切除造成的广泛缺损用Marlex网片覆盖在大网膜瓣上进行修补，大网膜瓣作为接受部分厚度皮肤移植的受体。这种复合重建恢复了胸廓有效的呼吸运动，表现为无前胸壁反常呼吸，床边测量的术后肺功能测定值为术前的75%。然而，在术后初期，需要机械通气辅助治疗成人呼吸窘迫综合征，该综合征与轻度前胸壁反常呼吸一起使得早期拔管不可能实现。
