Anterior chest wall reconstruction with titanium plate sandwiched between two polypropylene sheets

Abstract

Extensive sternal resection carries the risk of difficult reconstruction and surgical complications. A 79-year-old woman underwent sternal resection and reconstruction for sternal chondrosarcoma. However, 18 months after the first operation, she developed six metastatic tumors on the anterior chest wall. She underwent subtotal sternectomy and rib resection, leaving a defect measuring 17 × 14 cm. Reconstruction of the anterior chest wall using a titanium plate sandwiched between two polypropylene mesh sheets is described. This method is potentially applicable to extensive anterior chest resection, and its advantages compared with conventional prostheses are rigidity, flexibility, and usability.

Value of Porous Titanium Alloy Plates for Chest Wall Reconstruction after Resection of Chest Wall Tumors

“…In 2013, Berthet et al conducted chest wall reconstruction with titanium alloy plates on 11 patients with primary or secondary chest wall infections, and none had recurrent infection 6 months after operation except 1 died, therefore the authors believed that osseous chest wall reconstruction with titanium alloy plates concomitant with tissue repair had reliable, safe and rapid clinical efficacy on patients with severe chest wall infections (Berthet et al, 2013). Matsumoto et al reported the application of chest wall reconstruction with titanium alloy plate on 1 case of chest wall chondrosarcoma with chest wall defect 17×14 cm in size after surgical resection and the result showed that no scoliosis was found during 12 months of follow-up after operation and the thorax movement range was satisfactory (Matsumoto et al, 2012).…”

Long-Term Results of Chest Wall Reconstruction After Tumor Resection Using TiNi Implants

“…Radical operations in tumors, traumatic injuries, cardiosurgery intervention sequences lead to the necessity of replacing defects of the rib bar [1 ,2, 3]. А variety defects of available reconstructive techniques, first of all, testifies to the lack of а multipurpose effective method of the chest rib replacement [4,5,6,7]. The main demands for the implants are the following: biocompatibility, corrosion stability, ability to maintain the fixed form for а long time [8,9,10].…”

A Novel Clinical Application of the Classical Bakamjian Flap in the Reconstruction of a Sternal Chondrosarcoma Defect

“…This tumour appears as a radiolucent mass originating from the medullary region of the bone and is usually associated with cortical destruction and stippled calcification. Surgery in the form of radical en bloc excision and immediate reconstruction is the key to the management of primary sarcomas of the sternum [2][3][4][5][6][7]. Surgery alone is potentially curative in a majority of the cases, with the 10-year survival rate approaching 97 %.…”

“…Sternal resection can potentially result in large defects requiring complex reconstructions and various reconstruction techniques using prosthetic or homologous materials that have been described [2][3][4][5][6][7]. Skeletal reconstruction is considered not necessary for defects <5 cm in diameter.…”

“…Chest wall stability is generally achieved by reconstruction of skeletal defect with synthetic meshes such as polypropylene or polytetrafluoroethylene (Marlex) with or without methyl methacrylate reinforcement. The other options include the titanium meshes and metallic implants and the use of allografts [4][5][6]. A double-layer polypropylene mesh with methyl methacrylate reinforcement was used to achieve chest wall stability in our patient [4].…”