JEDLIČKA, Václav, Petr VLČEK, Jiří VESELÝ, Lenka VEVERKOVÁ, Ivan ČAPOV and Pavel JANÍČEK. Resekce a rekonstrukce hrudní stěny pro primární či metastatické nádorové onemocnění (Resection and Reconstruction of the Chest Wall for Primary or Metastatic Tumours). Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. 2011, vol. 78, No 4, p. 361-366. ISSN 0001-5415.
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Basic information
Original name Resekce a rekonstrukce hrudní stěny pro primární či metastatické nádorové onemocnění
Name (in English) Resection and Reconstruction of the Chest Wall for Primary or Metastatic Tumours
Authors JEDLIČKA, Václav (203 Czech Republic, guarantor, belonging to the institution), Petr VLČEK (203 Czech Republic, belonging to the institution), Jiří VESELÝ (203 Czech Republic, belonging to the institution), Lenka VEVERKOVÁ (203 Czech Republic, belonging to the institution), Ivan ČAPOV (203 Czech Republic, belonging to the institution) and Pavel JANÍČEK (203 Czech Republic, belonging to the institution).
Edition Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca, 2011, 0001-5415.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.628 in 2009
RIV identification code RIV/00216224:14110/11:00053171
Organization unit Faculty of Medicine
UT WoS 000295191900013
Keywords in English chest wall tumour; complications; advanced disease; soft tissue coverage
Tags International impact
Changed by Changed by: Mgr. Michal Petr, učo 65024. Changed: 25/1/2012 12:33.
Abstract
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.
Abstract (in English)
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.
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