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Abstract：
Background and Objectives: Chest wall defect reconstruction is a complex procedure aimed at restoring thoracic structural integrity after trauma, tumor removal, or congenital issues. In this study, postoperative complications were investigated to improve the care of patients with these critical conditions. Materials and Methods: A retrospective study of chest wall reconstructions from 2004 to 2023 was conducted at Klinikum Nürnberg and Evangelisches Waldkrankenhaus Spandau-Berlin. Data included patient demographics, comorbidities, defect etiology, surgery details, and complications using the Clavien-Dindo classification. Results: Among the 30 patients included in the study, a total of 35 complications occurred in 35 thoracic wall defect reconstructions. These complications were classified into 22 major and 13 minor cases. Major complications were more common in patients with cancer-related defects, and considerable variations were observed between free flap and pedicled flap surgeries. Notably, the use of the anterolateral thigh (ALT) flap with vastus lateralis muscle demonstrated promise, exhibiting fewer complications in select cases. The reconstruction of chest wall defects is associated with substantial complications regardless of the etiology of the defect and the particular surgical procedure used. Interestingly, there was a lower complication rate with free flap surgery than with pedicled flaps. Conclusions: The ALT flap with vastus lateralis muscle deserves further research in this field of reconstruction. Multidisciplinary approaches and informed patient discussions are crucial in this complex surgical field, emphasizing the need for ongoing research and technique refinement.
摘要：
背景与目的：胸壁缺损重建是一项复杂的手术，旨在恢复创伤后胸部结构的完整性。肿瘤切除,或先天性问题。在这项研究中,对术后并发症进行调查，以改善对这些危重患者的护理。材料与方法：2004年至2023年在纽伦堡Klinikum和EvangelischesWaldkrankenhausSpandau-Berlin进行了胸壁重建的回顾性研究。数据包括患者人口统计，合并症,缺陷病因，手术细节,和使用Clavien-Dindo分类的并发症。结果：在纳入研究的30例患者中，35例胸壁缺损重建术共发生35例并发症。这些并发症分为22例主要病例和13例次要病例。主要并发症在癌症相关缺陷患者中更为常见，在游离皮瓣和带蒂皮瓣手术之间观察到相当大的差异。值得注意的是,使用股前外侧（ALT）皮瓣与股外侧肌表现出希望，在某些情况下表现出更少的并发症。胸壁缺损的重建与大量并发症有关，而与缺损的病因和所使用的特定外科手术无关。有趣的是,游离皮瓣手术的并发症发生率低于带蒂皮瓣。结论：带有股外侧肌的ALT皮瓣在重建领域值得进一步研究。在这个复杂的外科领域，多学科方法和知情的患者讨论至关重要。强调需要持续的研究和技术改进。
