González Muñoz J I, Córdoba Peláez M, Tebar Boti E, Téllez Cantero J C, Castedo Mejuto E, Varela de Ugarte A
Servicio de Cirugía Torácica y Cardiovascular, Clínica Puerta de Hierro, Madrid.
Arch Bronconeumol. 1997 Jan;33(1):27-30. doi: 10.1016/s0300-2896(15)30674-8.
Thoracic wall resections are performed to treat a wide variety of conditions. Reconstruction techniques have varied considerably since the introduction of synthetic prosthesis, the most recent of which are made of polytetrafluoroethylene (PTFE, or Gore-Tex). We describe our department's experience with PTFE prosthesis. PTFE was used in 21 patients treated for various diseases. Thirteen reconstructions were of the thoracic wall, 4 were of the diaphragm and 4 of the pericardium. Three of the 13 thoracic wall reconstructions involved bilateral myoplasty of the pectoralis major, 2 involved omentoplasty and 1 required use of a wide musculocutaneous flap. Complications included pneumonia in 2 cases and 1 seroma with chronic cutaneous fistula that required removal of the prosthesis after 9 months. Two patients died, 1 after 19 days and the other after 9 months, both as a result of causes unrelated to reconstruction. Follow-up of these patients ranged from 3 to 54 months. We recommend the prosthetic use of PTFE for thoracic wall reconstruction, along with plasty or musculocutaneous flaps when necessary.
胸壁切除术用于治疗多种病症。自从合成假体引入以来,重建技术有了很大变化,最新的假体由聚四氟乙烯(PTFE,即 Gore-Tex)制成。我们描述了我们科室使用 PTFE 假体的经验。PTFE 用于 21 例因各种疾病接受治疗的患者。13 例为胸壁重建,4 例为膈肌重建,4 例为心包重建。13 例胸壁重建中,3 例涉及双侧胸大肌肌成形术,2 例涉及网膜成形术,1 例需要使用宽肌皮瓣。并发症包括 2 例肺炎和 1 例血清肿伴慢性皮肤瘘,9 个月后需要取出假体。2 例患者死亡,1 例在 19 天后,另 1 例在 9 个月后,均因与重建无关的原因死亡。这些患者的随访时间为 3 至 54 个月。我们建议在胸壁重建中使用 PTFE 假体,并在必要时联合整形或肌皮瓣。