Handa M, Susukida K, Sakuma T, Okaniwa G, Kondo T, Fujimura S
Department of Surgery, Sendai Kosei Hospital, Japan.
Kyobu Geka. 1996 Jan;49(1):48-52.
Wide resection of the chest wall requires reconstruction with rigid prosthetic material to protect the thoracic organs and to avoid flail chest. We tried to use three kinds of plates for chest wall reconstruction in 4 cases: acrylic plate for 1, ultra-high-molecular-weight polyethylene (UHMWP) plate for 1 and methyl metacrylic resin (MMR) plate for 2. Marlex mesh was utilized to strengthen the rebuilt chest wall sandwiching rigid prosthesis in UHMWP plate and MMR plate. Except for somewhat local accumulation of serous fluid in two cases of acrylic plate and MMR plate, postoperative courses were uneventful in all cases. Acrylic plate which was used for patient with metastatic sternal tumor was easily damaged by heat. UHMWP plate which was used for patient with large benign sternal tumor was expensive and took a long time to make. On the other hand, MMR plates which were used for two patients with malignant lateral chest wall tumor were easy to handle on the spot and not expensive. MMR plate sandwiched by Marlex mesh seems to be more suitable and available for chest wall reconstruction.
胸壁广泛切除需要用坚硬的假体材料进行重建，以保护胸腔器官并避免连枷胸。我们尝试用三种板材对4例患者进行胸壁重建：1例用丙烯酸板，1例用超高分子量聚乙烯（UHMWP）板，2例用甲基丙烯酸树脂（MMR）板。在UHMWP板和MMR板重建中，使用Marlex网来加强夹有刚性假体的重建胸壁。除了丙烯酸板和MMR板各有2例出现局部浆液性积液外，所有病例术后过程均顺利。用于转移性胸骨肿瘤患者的丙烯酸板易受热损坏。用于巨大良性胸骨肿瘤患者的UHMWP板价格昂贵且制作耗时。另一方面，用于2例恶性侧胸壁肿瘤患者的MMR板现场操作简便且价格不贵。夹有Marlex网的MMR板似乎更适合且可用于胸壁重建。
