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Surgical treatment of chest wall tumors (resection and reconstruction) A six years experience

机译:胸壁肿瘤的外科治疗(切除和重建)六年经验

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Background: Chest wall resection and reconstruction remains one of the most challenging areas of Thoracic & Plastic Surgery. The purpose of this study is to report our 6-year experience with chest wall resections and reconstructions. Methods: A retrospective review of 36 patients who had chest wall resections from 1998 to 2003 was performed. Result: Patient demographics included tobacco abuse, hypertension, diabetes mellitus, niswar abuse, coronary artery disease, chronic obstructive pulmonary disease, and HCV +ve. Surgical indications included chest wall tumors, and lung cancer involving the chest wall. The mean number of ribs resected was 4?±2 ribs. Thirty four patients underwent chest wall resections. Two patients underwent right upper lobectomy along with chest wall resections. Immediate closure was performed in all 36 patients. Primary repair without the use of reconstructive techniques was possible in 9 patients. Synthetic chest wall reconstruction was performed using Prolene mesh, Marlex mesh, methyl methacrylate sandwich, and polytetrafluoroethylene. Flaps utilized for soft tissue coverage were pedicled flaps (2 patients). Mean postoperative length of stay was 14?±12 days. Mean intensive care unit stay was 5+4 days. In-hospital and 30-day survival was 100%. Conclusions: Chest wall resection with reconstruction can be performed as a safe, effective one-stage surgical procedure for a variety of major chest wall defects.
机译:背景:胸壁切除和重建仍然是胸外科和整形外科最具挑战性的领域之一。这项研究的目的是报告我们在胸壁切除和重建方面的6年经验。方法:回顾性分析1998年至2003年间36例行胸壁切除术的患者。结果:患者的人口统计数据包括烟草滥用,高血压,糖尿病,尼瓦尔战争,冠状动脉疾病,慢性阻塞性肺疾病和HCV + ve。手术适应症包括胸壁肿瘤和涉及胸壁的肺癌。切除的肋骨平均数为4±±2肋骨。 34例患者接受了胸壁切除术。两名患者接受了右上肺叶切除以及胸壁切除术。所有36例患者均立即关闭。 9例患者无需修复即可进行初次修复。使用Prolene筛网,Marlex筛网,甲基丙烯酸甲酯三明治和聚四氟乙烯进行合成胸壁重建。带蒂皮瓣用于软组织覆盖(2例)。术后平均住院时间为14±12天。重症监护病房平均住院时间为5 + 4天。住院和30天生存率为100%。结论:胸壁切除再造术可作为多种主要胸壁缺损的安全,有效的一阶段手术程序。

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