PDF(Pubmed)
Abstract：
UNASSIGNED: Musculoskeletal transfer for chest wall tissue defects is a crucial method, and pedicled flaps around the chest wall are preferred in terms of location and simplicity of transfer. These require special care because of complications such as partial necrosis, fistula, wound dehiscence, infection, hematoma and restricted function of the arm or shoulder. However, studies of respiratory function are rare. In the present study, we investigated the complications including respiratory problems after wide resection for malignant chest wall tumors with musculoskeletal pedicle transfer.
UNASSIGNED: A total of 13 patients (15 operations) who underwent wide resection of primary, recurrent, or metastatic malignant chest wall tumors and musculoskeletal pedicle transfer for coverage of tissue defects were enrolled in the present study. A retrospective review of all patients was performed using data collected from hospital records and follow-up information. The complications of musculoskeletal transfer after chest wall wide resection, including respiratory problems, are evaluated.
UNASSIGNED: Rib or sternal resection was performed in 12 operations, and only soft tissue resection was performed in 3 operations. Latissimus dorsi (LD) pedicle transfer was performed in 13 operations, and pectoralis major (PM) pedicle transfer was performed in 2 operations; basically, wounds were closed primarily. Surgical complications were observed following 5 of the 15 operations (33.3%). Respiratory complications were seen in 7 of the 15 operations (46.7%). Patients with respiratory complications showed significantly lower preoperative FEV1.0% values than those without respiratory complications (p = 0.0196). Skin resection area tended to be higher in the complication group than in the no complication group (p = 0.104).
UNASSIGNED: Pedicled myocutaneous flap transfers such as LD, PM, and rectus abdominus can be used following multiple resections. After harvesting LD or PM, the wound can be closed primarily for an 8-10-cm skin defect in patients with normal respiratory function. However, for patients with low FEV1.0%, after primary closure of LD or PM transfer for wide soft tissue defects, attention should be paid to postoperative respiratory complications.
UNASSIGNED: A total of 13 patients (15 operations) who underwent wide resection of primary, recurrent, or metastatic malignant chest wall tumors and musculoskeletal pedicle transfer for coverage of tissue defects were enrolled in the present study. A retrospective review of all patients was performed using data collected from hospital records and follow-up information. The complications of musculoskeletal transfer after chest wall wide resection, including respiratory problems, are evaluated.
UNASSIGNED: Rib or sternal resection was performed in 12 operations, and only soft tissue resection was performed in 3 operations. Latissimus dorsi (LD) pedicle transfer was performed in 13 operations, and pectoralis major (PM) pedicle transfer was performed in 2 operations; basically, wounds were closed primarily. Surgical complications were observed following 5 of the 15 operations (33.3%). Respiratory complications were seen in 7 of the 15 operations (46.7%). Patients with respiratory complications showed significantly lower preoperative FEV1.0% values than those without respiratory complications (p = 0.0196). Skin resection area tended to be higher in the complication group than in the no complication group (p = 0.104).
UNASSIGNED: Pedicled myocutaneous flap transfers such as LD, PM, and rectus abdominus can be used following multiple resections. After harvesting LD or PM, the wound can be closed primarily for an 8-10-cm skin defect in patients with normal respiratory function. However, for patients with low FEV1.0%, after primary closure of LD or PM transfer for wide soft tissue defects, attention should be paid to postoperative respiratory complications.
摘要：
■肌肉骨骼移植是治疗胸壁组织缺损的重要方法，在位置和转移的简单性方面，胸壁周围的带蒂皮瓣是首选。这些需要特别的护理，因为并发症，如部分坏死，瘘管,伤口裂开,感染,血肿和手臂或肩部功能受限。然而,对呼吸功能的研究很少。在本研究中,我们调查了恶性胸壁肿瘤伴肌肉骨骼蒂转移的广泛切除术后的并发症，包括呼吸系统问题。
■共有13例患者（15例手术）接受了广泛的原发性切除术，经常性,本研究纳入了转移性恶性胸壁肿瘤和肌肉骨骼蒂转移以覆盖组织缺损。使用从医院记录和随访信息收集的数据对所有患者进行回顾性审查。胸壁广泛切除术后肌肉骨骼转移的并发症，包括呼吸问题,进行了评估。
■在12个手术中进行了肋骨或胸骨切除术，3例仅进行软组织切除。在13个手术中进行了背阔肌（LD）椎弓根转移，在2次手术中进行了胸大肌（PM）椎弓根转移；基本上，伤口主要是闭合的。15例手术中有5例（33.3％）观察到手术并发症。15例手术中有7例（46.7％）出现呼吸道并发症。有呼吸道并发症的患者术前FEV1.0%值明显低于无呼吸道并发症的患者(p=0.0196)。并发症组的皮肤切除面积高于无并发症组（p=0.104）。
■带蒂肌皮瓣转移，如LD，PM,腹直肌可以在多次切除后使用。收获LD或PM后，对于呼吸功能正常的患者，伤口主要是8-10厘米的皮肤缺损。然而,对于低FEV1.0%的患者，在广泛的软组织缺损的LD或PM转移的初次闭合后，术后应注意呼吸道并发症。
■共有13例患者（15例手术）接受了广泛的原发性切除术，经常性,本研究纳入了转移性恶性胸壁肿瘤和肌肉骨骼蒂转移以覆盖组织缺损。使用从医院记录和随访信息收集的数据对所有患者进行回顾性审查。胸壁广泛切除术后肌肉骨骼转移的并发症，包括呼吸问题,进行了评估。
■在12个手术中进行了肋骨或胸骨切除术，3例仅进行软组织切除。在13个手术中进行了背阔肌（LD）椎弓根转移，在2次手术中进行了胸大肌（PM）椎弓根转移；基本上，伤口主要是闭合的。15例手术中有5例（33.3％）观察到手术并发症。15例手术中有7例（46.7％）出现呼吸道并发症。有呼吸道并发症的患者术前FEV1.0%值明显低于无呼吸道并发症的患者(p=0.0196)。并发症组的皮肤切除面积高于无并发症组（p=0.104）。
■带蒂肌皮瓣转移，如LD，PM,腹直肌可以在多次切除后使用。收获LD或PM后，对于呼吸功能正常的患者，伤口主要是8-10厘米的皮肤缺损。然而,对于低FEV1.0%的患者，在广泛的软组织缺损的LD或PM转移的初次闭合后，术后应注意呼吸道并发症。
