Arnold P G, Pairolero P C
Ann Surg. 1984 Jun;199(6):725-32. doi: 10.1097/00000658-198406000-00011.
Experience with 100 consecutive chest wall reconstructions during the past 7 years was reviewed. There were 52 female and 48 male patients with ages ranging from 13 to 78 years (average 53). Of the 100 patients, 42 had tumors of the chest wall, 19 had radiation necrosis, 24 had infected median sternotomies , and 15 had combinations of the three. Seventy-six patients underwent skeletal resection of the chest wall. An average of 5.7 ribs were resected in 63 patients. Total or partial sternectomies were performed in 29. Ninety-two patients underwent 142 muscle flaps: 77 pectoralis major, 29 latissimus dorsi, and 36 other muscles, including serratus anterior, rectus abdominis, and external oblique muscles. The omentum was transposed in ten patients. Chest wall skeletal defects were closed with Prolene mesh in 29 patients and with autogenous ribs in 11. Eighty-nine patients underwent primary closure of the skin. The 100 patients underwent an average of 2.1 operations. Hospitalization averaged 17.5 days. There was one perioperative death (29 days). Two patients required tracheostomy. Follow-up averaged 21.6 months. There were 24 late deaths. All 99 patients who were alive 30 days after operation had excellent results at the time of death or last follow-up.
回顾了过去7年连续100例胸壁重建手术的经验。患者中女性52例，男性48例，年龄13至78岁（平均53岁）。100例患者中，42例患有胸壁肿瘤，19例有放射性坏死，24例有正中胸骨切开术后感染，15例为三者并存。76例患者接受了胸壁骨骼切除术。63例患者平均切除5.7根肋骨。29例行全胸骨或部分胸骨切除术。92例患者接受了142块肌皮瓣移植：77块胸大肌，29块背阔肌，36块其他肌肉，包括前锯肌、腹直肌和腹外斜肌。10例患者行大网膜移位术。29例患者用普理灵网片闭合胸壁骨骼缺损，11例用自体肋骨闭合。89例患者一期缝合皮肤。100例患者平均接受2.1次手术。平均住院17.5天。围手术期死亡1例（术后29天）。2例患者需要气管切开术。平均随访21.6个月。有24例晚期死亡。术后30天存活的99例患者在死亡或最后一次随访时效果良好。
