Effectiveness of reconstruction with titanium plate and prolene mesh after resection of malignant chest wall tumors
Öz
Aim: Many reconstruction methods have been reported to close the defect after resection of malignant chest wall tumors. The aim of this work is to evaluate the clinical effectiveness of the reconstruction method we applied with titanium plate and prolene mesh after resection.
Materials and Methods: Titanium plate and prolene mesh were used to close the defect in 11 patients who underwent chest wall resection with the diagnosis of malignant chest wall tumor between January 2010 and December 2019. The diagnosis was chondrosarcoma in 4, metastasis of ductal carcinoma of the breast in 3, ewing sarcoma in 2, chest wall invasion of non-small cell lung carcinoma in 1, and solitary plasmacytoma in 1 patient. Resection including 2-4 cm normal tissue, lower and upper ribs was performed with tumor in all patients. Perioperative surgical limits were shown to be negative by studying frozen.
Results: There were 7 males (63%) and 4 females (36%) with a mean age of 62±3.4 years. Apart from rib resection, 2 had partial sternum, 1 had lung and 1 patient had diaphragmatic resection. In 3 patients, soft tissue reconstruction was applied in addition to titanium plate and prolene mesh application. Postoperative complications were seen in 4 of the patients. Wound infection occurred in 2 patients, pneumonia in 1 patient, and atelectasis in another patient. The intensive care hospital stay was 1.83±1.13 (2-5), and the hospital stay was 6.34±2.13 (5-16). The patients were followed up for an average of 23±4.5 (12-38) months. Local recurrence was detected in 1 patient during follow-up.
Conclusion: In order to prevent local recurrence in malignant chest wall tumors, frozen should be sent in 4 directions after resection. Titanium plate and prolene mesh combination is an effective and easy method with low morbidity and infection for the reconstruction of the chest wall.
Anahtar Kelimeler
Resection of chest wall , Titanyum plate prolene mesh effectiveness
Kaynakça
- 1. Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg 1996; 98: 804-10.
- 2. Deschamps C, Tirnaksiz BM, Darbandi R, Trastek VF, Allen MS, Miller DL, et al. Early and long-term results of prosthetic chest wall reconstruction. J Thorac Cardiovasc Surg 1999; 117: 588- 91.
- 3. Chapelier AR, Missana MC, Couturaud B, Fadel E, Fabre D, Mussot S, et al. Sternal resection and reconstruction for primary malignant tumors. Ann Thorac Surg 2004; 77: 1001-6.
- 4. Kaya ŞÖ, Usluer O, Yakut FC. Göğüs duvarı rezeksiyon ve rekonstrüksiyonu. Turkiye Klinikleri J Thor Surg-Special Topics 2018; 9: 155- 9.
- 5. Shamberger RC, Laquaglia MP, Krailo MD, Miser JS, Pritchard DJ, Gebhardt MC, et al. Ewing sarcoma of the rib: results of an intergroup study with analysis of outcome by timing of resection. J Thorac Cardiovasc Surg 2000; 119: 1154- 61.
- 6. Welker JA, Henshaw RM, Jelinek J, Shmookler BM, Malawer MM. The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 2000; 89: 2677- 86.
- 7. Parikh M, Samujh R, Kanojia RP, et al. Peripheral primitive neuroectodermal tumor of the chest wall in childhood: clinico-pathological significance, management and literature review. Chang Gung Med J 2011; 34: 213- 7.
- 8. Sanna S, Brandolini J, Pardolesi A, et al. Materials and techniques in chest wall reconstruction: a review. J Vis Surg 2017; 3: 95.
- 9. Dell'Amore A, Cassanelli N, Dolci G, et al. An alternative technique for anterior chest wall reconstruction: the sternal allograft transplantation. Interact Cardiovasc Thorac Surg 2012; 15: 944- 7.
- 10. Mansour KA, Thourani VH, Losken A, et al. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg 2002; 73: 1720- 5.
- 11. Deschamps C, Tirnaksiz BM, Darbandi R, et al. Early and long-term results of prosthetic chest wall reconstruction. J Thorac Cardiovasc Surg 1999; 117: 588- 91.
- 12. Leuzzi G, Nachira D, Cesario A, et al. Chest wall tumors and prosthetic reconstruction: A comparative analysis on functional outcome. Thorac Cancer 2015; 6: 247- 54.
- 13. Marulli G, Dell'amore A, Calabrese F, et al. Safety and Effectiveness of Cadaveric Allograft Sternochondral Replacement After Sternectomy: A New Tool for the Reconstruction of Anterior Chest Wall. Ann Thorac Surg 2017; 103: 898- 905.
- 14. Iarussi T, Pardolesi A, Camplese P, et al. Composite chest wall reconstruction using titanyum plates and mesh preserves chest wall function. J Thorac Cardiovasc Surg 2010; 140: 476- 7.
- 15. Tamburini N, Grossi W, Sanna S, Campisi A, Londero F, Maniscalco P, Dolci G, Quarantotto F, Daddi N, Morelli A, Cavallesco G, Dell'Amore A. Chest wall reconstruction using a new titanyum mesh: a multicenters experience. J Thorac Dis. 2019; 11: 3459- 66.
- 16. Berthet JP, Solovei L, Tiffet O, et al. Chest-wall reconstruction in case of infection of the operative site: is there any interest in titanyum rib osteosynthesis? Eur J Cardiothorac Surg 2013; 44: 866- 74.
- 17. Arens S, Schlegel U, Printzen G, et al. Influence of materials for fixation implants on local infection. An experimental study of steel versus titanyum DCP in rabbits. J Bone Joint Surg Br 1996; 78: 647- 51.
- 18. Lans TE, van der Pol C, Wouters MW, et al. Complications in wound healing after chest wall resection in cancer patients; a multivariate analysis of 220 patients. J Thorac Oncol 2009; 4: 639- 43.
- 19. Widhe B, Bauer HC; Scandinavian Sarcoma Group. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg 2009; 137: 610- 4.
- 20. David EA, Marshall MB. Review of chest wall tumors: a diagnostic, therapeutic, and reconstructive challenge. Semin Plast Surg 2011; 25: 16- 24.
- 21. King RM, Pairolero PC, Trastek VF, Piehler JM, Payne WS, Bernatz PE. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg 1986; 41: 597- 601.
- 22. Burt M, Fulton M, Wessner-Dunlap S, et al. Primary bony and cartilaginous sarcomas of chest wall: results of therapy. Ann Thorac Surg 1992; 54: 226- 32.
- 23. McAfee MK, Pairolero PC, Bergstralh EJ. Chondrosarcoma of the chest wall: factors affecting survival. Ann Thorac Surg 1985; 40: 535- 41.
- 24. Walsh GL, Davis BM, Swisher SG, et al. A single institutional multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. Journal of Thoracic and Cardiovascular Surg 2001; 121: 48- 60.
Malign göğüs duvarı tümörlerinin rezeksiyonu sonrası titanyum plak ve prolen meş ile rekonstrüksiyonun etkinliği
Öz
Amaç: Malign göğüs duvarı tümörlerinin rezeksiyonu sonrası oluşan defekti kapatmak için birçok rekonstrüksiyon yöntemi bildirilmiştir. Bu çalışmada amacımız rezeksiyon sonrası titanyum plak ve prolen meş ile uyguladığımız rekonstrüksiyon metodunun klinik etkinliğini ortaya koymaktır.
Gereç ve Yöntemler: 2010 Ocak ile 2019 Aralık arası malign göğüs duvarı tümörü tanısı ile göğüs duvarı rezeksiyonu uygulanan 11 hastaya, oluşan defekti kapatmak için titanyum plak ve prolen meş kullanıldı. Tanı 4 hastada kondrosarkoma, 3 hastada memenin duktal karsinomunun metastazı, 2 hastada ewing sarkomu, 1 hastada küçük hücreli dışı akciğer karsinomunun göğüs duvarı invazyonu, 1 hastada soliter plazmositoma idi. Tüm hastalarda tümör ile birlikte 2-4 cm normal doku, bir alt ve bir üst kaburga içeren rezeksiyon uygulandı. Peroperatif cerrahi sınırlar frozen çalışılarak negatif olduğu gösterildi.
Bulgular: Hastaların 7’si (%63) erkek, 4’ü (%36) bayan, ortalama yaş 62±3.4 idi. Kaburga rezeksiyonu dışında 2 hastada parsiyel sternum, 1 hastada akciğer ve 1 hastada diyafragma rezeksiyonu uygulandı. Üç hastada titanyum plak ve prolen meş uygulamasına ilave olarak yumuşak doku rekonstrüksiyonu uygulandı. Hastaların 4’ünde postoperatif komplikasyon görüldü. İki hastada yara yeri enfeksiyonu, 1 hastada pnömoni, diğer 1 hastada atelektazi gelişti. Yoğun bakım yatış süresi 1.83±1.13 (2-5), hastanede yatış süresi 6.34±2.13 (5-16) idi. Hastalar ortalama 23±4.5 (12-38) ay takip edildi. Takipte 1 hastada lokal rekürrens saptandı.
Sonuç: Malign göğüs duvarı tümörlerinde lokal rekürrensi önlemek amaçlı rezeksiyon sonrası 4 yönden frozen gönderilmelidir. Göğüs duvarının rekonstrüksiyonu için Titanyum plak ve prolen meş kombinasyonu morbiditesi ve enfeksiyon riski düşük, etkin ve kolay bir yöntemdir.
Anahtar Kelimeler
Kaynakça
- 1. Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg 1996; 98: 804-10.
- 2. Deschamps C, Tirnaksiz BM, Darbandi R, Trastek VF, Allen MS, Miller DL, et al. Early and long-term results of prosthetic chest wall reconstruction. J Thorac Cardiovasc Surg 1999; 117: 588- 91.
- 3. Chapelier AR, Missana MC, Couturaud B, Fadel E, Fabre D, Mussot S, et al. Sternal resection and reconstruction for primary malignant tumors. Ann Thorac Surg 2004; 77: 1001-6.
- 4. Kaya ŞÖ, Usluer O, Yakut FC. Göğüs duvarı rezeksiyon ve rekonstrüksiyonu. Turkiye Klinikleri J Thor Surg-Special Topics 2018; 9: 155- 9.
- 5. Shamberger RC, Laquaglia MP, Krailo MD, Miser JS, Pritchard DJ, Gebhardt MC, et al. Ewing sarcoma of the rib: results of an intergroup study with analysis of outcome by timing of resection. J Thorac Cardiovasc Surg 2000; 119: 1154- 61.
- 6. Welker JA, Henshaw RM, Jelinek J, Shmookler BM, Malawer MM. The percutaneous needle biopsy is safe and recommended in the diagnosis of musculoskeletal masses. Cancer 2000; 89: 2677- 86.
- 7. Parikh M, Samujh R, Kanojia RP, et al. Peripheral primitive neuroectodermal tumor of the chest wall in childhood: clinico-pathological significance, management and literature review. Chang Gung Med J 2011; 34: 213- 7.
- 8. Sanna S, Brandolini J, Pardolesi A, et al. Materials and techniques in chest wall reconstruction: a review. J Vis Surg 2017; 3: 95.
- 9. Dell'Amore A, Cassanelli N, Dolci G, et al. An alternative technique for anterior chest wall reconstruction: the sternal allograft transplantation. Interact Cardiovasc Thorac Surg 2012; 15: 944- 7.
- 10. Mansour KA, Thourani VH, Losken A, et al. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg 2002; 73: 1720- 5.
- 11. Deschamps C, Tirnaksiz BM, Darbandi R, et al. Early and long-term results of prosthetic chest wall reconstruction. J Thorac Cardiovasc Surg 1999; 117: 588- 91.
- 12. Leuzzi G, Nachira D, Cesario A, et al. Chest wall tumors and prosthetic reconstruction: A comparative analysis on functional outcome. Thorac Cancer 2015; 6: 247- 54.
- 13. Marulli G, Dell'amore A, Calabrese F, et al. Safety and Effectiveness of Cadaveric Allograft Sternochondral Replacement After Sternectomy: A New Tool for the Reconstruction of Anterior Chest Wall. Ann Thorac Surg 2017; 103: 898- 905.
- 14. Iarussi T, Pardolesi A, Camplese P, et al. Composite chest wall reconstruction using titanyum plates and mesh preserves chest wall function. J Thorac Cardiovasc Surg 2010; 140: 476- 7.
- 15. Tamburini N, Grossi W, Sanna S, Campisi A, Londero F, Maniscalco P, Dolci G, Quarantotto F, Daddi N, Morelli A, Cavallesco G, Dell'Amore A. Chest wall reconstruction using a new titanyum mesh: a multicenters experience. J Thorac Dis. 2019; 11: 3459- 66.
- 16. Berthet JP, Solovei L, Tiffet O, et al. Chest-wall reconstruction in case of infection of the operative site: is there any interest in titanyum rib osteosynthesis? Eur J Cardiothorac Surg 2013; 44: 866- 74.
- 17. Arens S, Schlegel U, Printzen G, et al. Influence of materials for fixation implants on local infection. An experimental study of steel versus titanyum DCP in rabbits. J Bone Joint Surg Br 1996; 78: 647- 51.
- 18. Lans TE, van der Pol C, Wouters MW, et al. Complications in wound healing after chest wall resection in cancer patients; a multivariate analysis of 220 patients. J Thorac Oncol 2009; 4: 639- 43.
- 19. Widhe B, Bauer HC; Scandinavian Sarcoma Group. Surgical treatment is decisive for outcome in chondrosarcoma of the chest wall: a population-based Scandinavian Sarcoma Group study of 106 patients. J Thorac Cardiovasc Surg 2009; 137: 610- 4.
- 20. David EA, Marshall MB. Review of chest wall tumors: a diagnostic, therapeutic, and reconstructive challenge. Semin Plast Surg 2011; 25: 16- 24.
- 21. King RM, Pairolero PC, Trastek VF, Piehler JM, Payne WS, Bernatz PE. Primary chest wall tumors: factors affecting survival. Ann Thorac Surg 1986; 41: 597- 601.
- 22. Burt M, Fulton M, Wessner-Dunlap S, et al. Primary bony and cartilaginous sarcomas of chest wall: results of therapy. Ann Thorac Surg 1992; 54: 226- 32.
- 23. McAfee MK, Pairolero PC, Bergstralh EJ. Chondrosarcoma of the chest wall: factors affecting survival. Ann Thorac Surg 1985; 40: 535- 41.
- 24. Walsh GL, Davis BM, Swisher SG, et al. A single institutional multidisciplinary approach to primary sarcomas involving the chest wall requiring full-thickness resections. Journal of Thoracic and Cardiovascular Surg 2001; 121: 48- 60.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | MAKALELER |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Kasım 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 4 Sayı: 3 |
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