Resekce a rekonstrukce hrudní stěny pro primární či metastatické nádorové onemocnění

JEDLIČKA, Václav, Petr VLČEK, Jiří VESELÝ, Lenka VEVERKOVÁ, Ivan ČAPOV a Pavel JANÍČEK. Resekce a rekonstrukce hrudní stěny pro primární či metastatické nádorové onemocnění. Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. 2011, roč. 78, č. 4, s. 361-366. ISSN 0001-5415.

Základní údaje

Originální název

Resekce a rekonstrukce hrudní stěny pro primární či metastatické nádorové onemocnění

Název anglicky

Resection and Reconstruction of the Chest Wall for Primary or Metastatic Tumours

Autoři

JEDLIČKA, Václav (203 Česká republika, garant, domácí), Petr VLČEK (203 Česká republika, domácí), Jiří VESELÝ (203 Česká republika, domácí), Lenka VEVERKOVÁ (203 Česká republika, domácí), Ivan ČAPOV (203 Česká republika, domácí) a Pavel JANÍČEK (203 Česká republika, domácí)

Vydání

Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca, 2011, 0001-5415

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Další údaje

Jazyk

čeština

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.628 v roce 2009

Kód RIV

RIV/00216224:14110/11:00053171

Organizační jednotka

Lékařská fakulta

UT WoS

000295191900013

Klíčová slova anglicky

chest wall tumour; complications; advanced disease; soft tissue coverage

Příznaky

Mezinárodní význam

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Anotace

V originále

The aim of the study was to assess mortality and the complication rate after the extensive resection of chest wall tumour and subsequent soft tissue reconstruction. We wanted to evaluate the justification for major surgery in the group of patients with primary or secondary tumours, including those with an advanced stage of disease. A total of 35 patients after major chest wall resection within an eight-year period (2000-2008) were analysed retrospectively. A major resection was defined as resection of 75 cm2 or more of full thickness of the chest wall. There were 19 cases of primary malignant tumour of the chest wall, 10 cases of secondary tumour, and 6 cases of benign or semi-malignant lesions. The chest was stabilised with the help of either polypropylene or a double layer mesh of polyester covered with polyurethane. For soft tissue reconstruction, a musculocutaneousflap was used in 18 cases. The number of resected ribs ranged from two to seven. The vertebral body was partially resected in four cases, and total sternectomy was performed in two cases. This surgery was carried out with potentially curative intent in 30 (85.7%) and with palliative intent in five patients (14.3%). No post-operative mortality occurred. The complication rate was 17.1 %. The one-year survival rate was 88.6 %. There were seven long-term survivors at 5 or more years after resection of the chest wall for soft tissue sarcoma. Local recurrence occurred in six patients (17.1%). Neither the type of prosthesis nor the type of surgical procedure influenced the complication rate. Complete resection of the chest wall is feasible even in advanced tumours without significant peri-operative morbidity and mortality. Major chest wall resection as a palliative procedure remains selective for motivated patients in a good physical condition but with low quality of life caused by a chest wall tumour.

Anglicky

The aim of the study was to assess mortality and the complication rate after the extensive resection of chest wall tumour and subsequent soft tissue reconstruction. We wanted to evaluate the justification for major surgery in the group of patients with primary or secondary tumours, including those with an advanced stage of disease. A total of 35 patients after major chest wall resection within an eight-year period (2000-2008) were analysed retrospectively. A major resection was defined as resection of 75 cm2 or more of full thickness of the chest wall. There were 19 cases of primary malignant tumour of the chest wall, 10 cases of secondary tumour, and 6 cases of benign or semi-malignant lesions. The chest was stabilised with the help of either polypropylene or a double layer mesh of polyester covered with polyurethane. For soft tissue reconstruction, a musculocutaneousflap was used in 18 cases. The number of resected ribs ranged from two to seven. The vertebral body was partially resected in four cases, and total sternectomy was performed in two cases. This surgery was carried out with potentially curative intent in 30 (85.7%) and with palliative intent in five patients (14.3%). No post-operative mortality occurred. The complication rate was 17.1 %. The one-year survival rate was 88.6 %. There were seven long-term survivors at 5 or more years after resection of the chest wall for soft tissue sarcoma. Local recurrence occurred in six patients (17.1%). Neither the type of prosthesis nor the type of surgical procedure influenced the complication rate. Complete resection of the chest wall is feasible even in advanced tumours without significant peri-operative morbidity and mortality. Major chest wall resection as a palliative procedure remains selective for motivated patients in a good physical condition but with low quality of life caused by a chest wall tumour.