Titanium plates support for chest wall reconstruction with Gore-Tex® dual mesh after sternochondral resection

Hamad, Abdel-Mohsen; Marulli, Giuseppe; Bulf, Renato; Rea, Federico

doi:10.1016/j.ejcts.2009.04.047

Cited by 29 publications

(20 citation statements)

References 8 publications

(9 reference statements)

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“…In recent years, considering the favorable experiences obtained with titanium implants in other fields of prosthetic surgery (orthopedics, maxillofacial surgery), titanium systems constituted by dedicated plates, splints and screws for the reconstruction and stabilization of the chest wall (Synthes ® , STRATOS TM ) have been produced by industry and the use of titanium has been introduced in the procedures of reconstruction after demolition for neoplastic disease, to fix fractures of the thoracic cage after trauma and sternal dehiscence-diastasis and to treat malformative disease (1,2,(4)(5)(6)(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

Palma¹,

Sollitto²,

Loizzi³

et al. 2016

J. Thorac. Dis.

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Background:We report short and long-term results with the dedicated Synthes ® titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. Results: Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV 1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. Conclusions: An optimal chest wall stabilization and reconstruction was achieved with the Synthes ® titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long-term restoration of a normal respiratory function was achieved, with minimal plates-related morbidity and chest pain. IntroductionChest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. The thoracic surgeon often has to deal with neoplastic, traumatic and malformative diseases affecting the chest wall and requiring the demolition and reconstruction or stabilization of the thoracic cage. For this purpose, many techniques have been proposed, including the use of various and different materials, but to date there are still no clear guidelines in the management of chest wall diseases.About 5 years ago, in 2010, a new dedicated titanium plates system (Synthes ® ) was introduced for the treatment of chest wall diseases and is nowadays available in the current practice of the thoracic surgeon (1,2). However, to the best of our knowledge, just one study about long-term outcome of patients in whom these plates were implanted, and only for post-traumatic chest wall stabilization, has been published (3). In our retrospective study we report short and long-term results obtained with this new system for the stabilization and reconstruction of the chest wall in neoplastic, traumatic and malformative diseases. Materials and methodsFrom January 2010 to December 2014, 27 consecutive patients (22 males, 5 females), with a median age of 60 years (range: 16-83 years), were treated with the dedicated Synthes ® titanium system (plates, splints and screws) for sternum and ribs reconstruction and stabilization (Synthes ® , Solothurn, Switzerland). In particular, we used both the dedicated sternal system (Sy...

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Section: Discussionmentioning

confidence: 99%

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

Palma¹,

Sollitto²,

Loizzi³

et al. 2016

J. Thorac. Dis.

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“…New materials, more prone to be rapidly incorporated into the host, are currently available for CW reconstruction (15,16): malleable or articulating titanium bars (17), cryopreserved homograft (18,19) and acellular soft tissue patches of bovine, porcine or human derivation (20,21), the latter ones characterized by near-physiological properties.…”

Section: A B C Dmentioning

confidence: 99%

Primary lung tumors invading the chest wall

et al. 2016

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Chest wall (CW) involvement occurs in approximately 5% of all primary lung neoplasms.According to the most recent TNM classification, lung tumors invading CW are classified as T3, and they represent approximately 45% of all T3 lung cancers. The most common clinical symptom at presentation is chest pain (>60%), which is highly specific of CW infiltration (>90%). Dyspnoea and hemoptysis are also described, especially in case of large lesions. A realistic chance to cure locally advanced tumors invading CW is a surgical resection, consisting in the excision of the primary lung cancer along with the involved CW (sometimes an "en-bloc" resection) and an appropriate lymph-nodal dissection. However, such patients are at high-risk of facing postoperative complications; prognosis mainly depends on: (I) the completeness of resection; and (II) the lymph-nodal involvement. Hence, due to these reasons (incidence, symptoms, prognosis, post-operative complications), such category of patients are to be carefully assessed preoperatively and if deemed practicable, surgery should be taken into consideration. In this view, the aim of this paper is to critically review the most recent series of lung tumors invading the CW, with a particular focus on patients' preoperative evaluation, surgical techniques, postoperative complications and overall outcome.

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“…Only a few reports describe chest wall reconstruction after sternal resection using Gore-Tex dual mesh [1][2][3], and few reports describe using a vascularized rib for thoracic cage support [4]. We present here, the initial results of our technique using Gore-Tex dual mesh and a vascularized osteomusculocutaneous flap with rib and latissimus dorsi for reconstruction of an anterior chest wall defect after wide sternochondral resection.…”

Section: Introductionmentioning

confidence: 86%

Vascularized rib support for chest wall reconstruction using Gore-Tex(R) dual mesh after wide sternochondral resection

Akiba

Takeishi

Kinoshita

et al. 2011

Interactive CardioVascular and Thoracic Surgery

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Only a few reports describe chest wall reconstruction after sternal resection using Gore-Tex dual mesh, and very few reports describe the use of a vascularized rib to support the thoracic cage. We present a case of a breast cancer patient who underwent anterior chest wall resection for recurrent sternal cancer. Her sternoclavicular joints bilaterally and lower sternum were divided using an electric saw. The bony chest wall was reconstructed using Gore-Tex dual mesh, and a vascularized rib was used to bridge the space between the clavicular heads to support the thoracic cage. The patient's postoperative course was uneventful, without complications, such as paradoxical respiration or pneumonia.

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Titanium plates support for chest wall reconstruction with Gore-Tex® dual mesh after sternochondral resection

Cited by 29 publications

References 8 publications

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system

Primary lung tumors invading the chest wall

Vascularized rib support for chest wall reconstruction using Gore-Tex(R) dual mesh after wide sternochondral resection

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