Sternal resection and reconstruction after malignant tumours

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• 作者：José M. Galbis Caravajal (1)
  Luis Yeste Sánchez (2)
  Carlos A. Fuster Diana (3)
  Ricardo Guijarro Jorge (1)
  Paula Fernández Ortiz (4)
  Pam J. Deaville (5)
  
• 关键词：Sternal tumours ; Recurrent breast cancer ; Chest wall reconstruction ; Prosthesis
• 刊名：Clinical and Translational Oncology
• 出版年：2009
• 出版时间：February 2009
• 年：2009
• 卷：11
• 期：2
• 页码：91-95
• 全文大小：320KB
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• 作者单位：José M. Galbis Caravajal (1)
  Luis Yeste Sánchez (2)
  Carlos A. Fuster Diana (3)
  Ricardo Guijarro Jorge (1)
  Paula Fernández Ortiz (4)
  Pam J. Deaville (5)
  
  1. Department of Thoracic Surgery, General Universitary Hospital of Valencia, Avda. Tres Cruces, 2, ES-46014, Valencia, Spain
  2. Department of Plastic, Reconstructive and Aesthetic Surgery Hand and Burn Unit Povisa Vigo, Pontevedra, Spain
  3. Department of General Surgery Breast Unit, General Universitary Hospital of Valencia, Valencia, Spain
  4. Department of Nursing, University of Cantabria Santander, Cantabria, Spain
  5. School of Life Sciences, Keele University, Keele, Staffordshire, UK
  

文摘

Aim We present our experience of the resection of sternal tumours (both primary and metastatic), followed by reconstruction of soft-tissue and skeletal defects with a mesh and musculocutaneous flap. Methods Eleven patients were included in this study, all of which underwent sternal tumour resection and immediate chest wall repair. Reconstruction was accomplished with prosthetic material (polytetrafluoroethylene [PTFE]), a sandwich of polypropylene (Marlex-methylmethacrylate or titanium/polypropylene) and a pedicled musculocutaneous flap (pectoralis major, latissimus dorsi or rectus abdominis). Sternal tumours may arise from both primary (chondrosarcoma and neurofibrosarcoma) and secondary (local recurrence of breast carcinoma and metastatic disease from other organs) disease. Results Extubation did not result in paradoxical respiration in any of the patients in the study. The post-operative mortality rate was seen to be zero. One patient with a PTFE prosthesis had chest failure requiring immediate intubation and posterior prosthesis replacement. One mesh was removed two months after surgery. There was local recurrence in one patient and five patients died from distal metastases. The final patient is still alive with metastases at the time of presenting our results. Conclusions Wide resection of sternal tumours provides good local control. Reconstruction with mesh and musculocutaneous flap is an effective technique for repairing such defects.