PDF(Pubmed)
Abstract：
UNASSIGNED: Primary and secondary chest wall tumors (bone, breast, and soft tissue), congenital defects, and chest wall osteoradionecrosis often require extensive full-thickness local excisions to guarantee safe oncological margins (in cases of tumors) and complex reconstruction to provide stabilization and good biomechanical results avoiding postoperative respiratory failure. Thus, a personalized approach is required when dealing with chest wall defects, and reconstruction is planned. This review summarizes failed chest wall reconstruction procedures, identifies causes of failure, and highlights principles for complex chest wall reconstruction post-failure.
UNASSIGNED: We performed a narrative review of the literature on PubMed, Scopus, ScienceDirect, and Google Scholar, including all the relevant studies published from 1970.
UNASSIGNED: The available experiences in literature are only anecdotic and no current guidelines or rules exist on this topic, also given to its rarity. Proper pre-surgical planning and a multidisciplinary team (MDT) discussion are crucial for complex cases such as infections and radiation-induced chest ulcers after previous surgical treatment. Procedures should eventually include thoracic wall debridement, necrotic tissue excision, pulse-jet lavage, prosthesis removal, and vacuum assisted closure (VAC) therapy as a bridge for chest wall re-reconstruction. Sternotomy wounds require wire and prosthesis removal, and the use of meshes or bone allografts. This review aims to summarize experiences and highlight surgical and oncologic principles for complex chest wall reconstruction after failure.
UNASSIGNED: This review summarizes literature experiences to identify common key points for chest wall reconstruction after failure and to give some advice to surgeons managing this rare, challenging surgery.
UNASSIGNED: We performed a narrative review of the literature on PubMed, Scopus, ScienceDirect, and Google Scholar, including all the relevant studies published from 1970.
UNASSIGNED: The available experiences in literature are only anecdotic and no current guidelines or rules exist on this topic, also given to its rarity. Proper pre-surgical planning and a multidisciplinary team (MDT) discussion are crucial for complex cases such as infections and radiation-induced chest ulcers after previous surgical treatment. Procedures should eventually include thoracic wall debridement, necrotic tissue excision, pulse-jet lavage, prosthesis removal, and vacuum assisted closure (VAC) therapy as a bridge for chest wall re-reconstruction. Sternotomy wounds require wire and prosthesis removal, and the use of meshes or bone allografts. This review aims to summarize experiences and highlight surgical and oncologic principles for complex chest wall reconstruction after failure.
UNASSIGNED: This review summarizes literature experiences to identify common key points for chest wall reconstruction after failure and to give some advice to surgeons managing this rare, challenging surgery.
摘要：
■原发性和继发性胸壁肿瘤（骨，乳房,和软组织)，先天性缺陷,胸壁放射性骨坏死通常需要广泛的全层局部切除，以确保安全的肿瘤切缘（在肿瘤的情况下）和复杂的重建，以提供稳定和良好的生物力学结果，避免术后呼吸衰竭。因此，在处理胸壁缺陷时需要个性化的方法，重建计划。这篇综述总结了失败的胸壁重建程序，确定失败的原因，并强调了复杂的胸壁重建失败后的原则。
■我们对PubMed，Scopus,ScienceDirect,和谷歌学者，包括1970年发表的所有相关研究。
■文献中的现有经验仅仅是无稽之谈，没有关于这一主题的现行指南或规则，也给了它的稀有性。适当的术前计划和多学科团队（MDT）讨论对于复杂病例至关重要，例如先前手术治疗后的感染和辐射诱发的胸溃疡。手术最终应包括胸壁清创术，坏死组织切除,脉冲喷射灌洗,假体移除,和真空辅助闭合（VAC）治疗作为胸壁重建的桥梁。胸骨切开术伤口需要去除金属丝和假体，以及使用网状物或同种异体骨移植。本文旨在总结经验，强调失败后复杂胸壁重建的外科和肿瘤学原则。
这篇综述总结了文献经验，以确定失败后胸壁重建的共同关键点，并为处理这种罕见情况的外科医生提供一些建议，具有挑战性的手术。
■我们对PubMed，Scopus,ScienceDirect,和谷歌学者，包括1970年发表的所有相关研究。
■文献中的现有经验仅仅是无稽之谈，没有关于这一主题的现行指南或规则，也给了它的稀有性。适当的术前计划和多学科团队（MDT）讨论对于复杂病例至关重要，例如先前手术治疗后的感染和辐射诱发的胸溃疡。手术最终应包括胸壁清创术，坏死组织切除,脉冲喷射灌洗,假体移除,和真空辅助闭合（VAC）治疗作为胸壁重建的桥梁。胸骨切开术伤口需要去除金属丝和假体，以及使用网状物或同种异体骨移植。本文旨在总结经验，强调失败后复杂胸壁重建的外科和肿瘤学原则。
这篇综述总结了文献经验，以确定失败后胸壁重建的共同关键点，并为处理这种罕见情况的外科医生提供一些建议，具有挑战性的手术。
