An innovative method of pediatric chest wall reconstruction using Surgisis and swinging rib technique

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• 作者：Carol Oliveira^a ; Mohammed Zamakhshary^a ; ^b ; ^c ; ^{MZamakhshary@MOH.gov.sa} ; Tariq Alfadda^b ; Fahad Alhabshan^b ; Hisham Alshalaan^b ; Stephen Miller^a ; Peter C.W. Kim^a
• 关键词：Poland syndrome ; Sternum abnormalities ; Congenital abnormalities ; Reconstructive surgical procedures ; Surgical mesh
• 刊名：Journal of Pediatric Surgery
• 出版年：2012
• 期刊代码：190_00223468
• 类别：med
• 出版时间：May, 2012
• 卷：47
• 期：5
• 页码：867-873
• 文件大小：924 K

摘要

Purpose

Herein, we describe a new surgical approach for chest wall reconstruction using a native supporting rib and Surgisis.

Methods

A retrospective review of 3 cases from 2 tertiary pediatric health care centers presenting with chest wall defects in the neonatal period was performed. Perioperative data were collected.

Results

Two chest wall deformities were diagnosed at birth (Poland syndrome and cleft sternum). One patient was diagnosed prenatally with a mediastinal mass. The first infant had absent ribs 2 through 9. He underwent chest wall reconstruction at 4 weeks of life because of difficulty weaning from ventilation related to paradoxical breathing. The hamartoma of the second asymptomatic patient was removed at 6 weeks. The third patient's V-shaped sternal defect encompassed through the upper two thirds of the sternum and was repaired at 6 months of age with intraoperative transesophageal echocardiogram monitoring. In all cases, Surgisis (collagen matrix) was used as an onlay patch. In 2 cases, a swinging rib acted supportive. Neither patient had intraoperative complications.

Conclusion

Surgisis is useful in pediatric chest wall reconstruction, particularly in combination with swinging ribs. The capacity for adaptation to the child's growth of this approach is crucial. Short-term safety is shown, but long-term assessment is required.