Jadczuk E
Katedry i Kliniki Chirurgii Klatki Piersiowej Akademii Medycznej w Gdańsku.
Wiad Lek. 1997;50(7-9):163-9.
Indications for sternectomy and chest wall resection are considered very carefully due to risk of disturbances in respiratory mechanics. It was assumed that the major respiratory component abnormality after sternectomy and chest wall resection is the excessive mobility of rib stumps left in situ, whereas, the chest defect itself is of lesser importance. 5 patients with sternal tumour and 56 patients with lung cancer were operated and the chest wall resection was performed. In reconstructing the chest wall, the greatest emphasis was laid on rib stump stabilisation. This was carried out by attaching the rib stumps to each other using single sutures. Thanks to this, the rib stumps formed a rigid ring around the defect. Especially, a case of complete sternectomy, in which stabilisation required the fixation of large number of rib stumps, indicates the correctness of this hypothesis.
由于存在呼吸力学紊乱的风险，胸骨切除术和胸壁切除术的适应症会被非常谨慎地考虑。据推测，胸骨切除术和胸壁切除术后主要的呼吸成分异常是留在原位的肋骨残端过度活动，而胸壁缺损本身的重要性较小。对5例胸骨肿瘤患者和56例肺癌患者进行了手术并实施了胸壁切除术。在重建胸壁时，最大的重点放在肋骨残端的稳定上。这是通过使用单根缝线将肋骨残端相互连接来实现的。由此，肋骨残端在缺损周围形成了一个刚性环。特别是一例完全胸骨切除术，其中稳定需要固定大量肋骨残端，这表明了这一假设的正确性。
