Correction of postpneumonectomy syndrome using a custom implant

McRae, Matthew; Detterbeck, Frank C.; Narayan, Deepak

doi:10.1136/bcr.11.2010.3523

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…The most common long-term complication requiring surgical revision was leakage of the prosthesis (8.9%). Following implant leakage, McRae et al reported the use of a custom-made implant with a wall three times thicker than the initial prosthesis with good results [ 10 ]. Shen et al described a case of re-do thoracotomy at 1 year post-operatively to remove the prosthesis due to symptom recurrence [ 1 ].…”

Section: Resultsmentioning

confidence: 99%

“…The exposed bronchial stump staple line can be a source of trauma to the prosthesis, resulting in leakage and symptom recurrence [ 24 ]. The use of prophylactic AlloDerm did not protect the implants from trauma [ 10 , 24 ]. McRae et al described the successful use of a custom-made tissue expander with a wall three times as thick as normal implants [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of prophylactic AlloDerm did not protect the implants from trauma [ 10 , 24 ]. McRae et al described the successful use of a custom-made tissue expander with a wall three times as thick as normal implants [ 10 ]. Custom made, patient-specific prostheses, as well as 3D carbon-fibre printed prostheses, have also been described with good results [ 5 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options

Christodoulides

Fitzmaurice

Bukowska

et al. 2023

J Cardiothorac Surg

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Objectives Post-pneumonectomy syndrome (PPS) is rare and predominantly characterised by dynamic airway obstruction due to mediastinal rotation at any time point following pneumonectomy. The objective of this systematic review was to identify the optimal treatment strategy for PPS based on subjective symptomatic relief, objective radiological imaging, and treatment durability. Methods A systematic review was performed up to and including February 2022 based on the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” guidelines. All studies that presented the management of symptomatic patients > 16 years of age with radiologically confirmed PPS were included. The primary outcome was the identification of the optimal treatment strategy and the secondary outcome was durability of the treatment. The Oxford Centre for Evidence Based Medicine level was assigned to each study. Results A total of 330 papers were identified and reviewed; 41 studies met the inclusion criteria. Data including patient demographics, indication for initial pneumonectomy, presenting symptoms, management approach, outcomes, and follow-up were assessed and analysed. Management approaches were divided into three categories: (a) mediastinal repositioning using implant prostheses; (b) endobronchial stenting; (c) other corrective procedures. One hundred and four patients were identified in total and of those, 87 underwent mediastinal repositioning with insertion of a prosthetic implant. Complications included over- or under-filling of the prosthesis (8.5%) and implant leakage (8.9%). Conclusion Management of PPS using a prosthetic implant to reposition the mediastinum is the treatment of choice. Key adjuncts to optimise surgical approach and minimise complications include pre-operative CT volumetric analysis to guide implant size and intra-operative transoesophageal echocardiography to guide mediastinal repositioning.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options

Christodoulides

Fitzmaurice

Bukowska

et al. 2023

J Cardiothorac Surg

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“…Conventional prosthetic implants for PPS therapy are silicone breast implants, 2 saline breast implants, and tissue expanders. 3,4 Because of their lack of rigidity, however, these traditional, flexible material prostheses are easily deformed and liable to shift out of position. It is difficult to maintain stable or reliable support in the mediastinum.…”

Section: E136mentioning

confidence: 99%

“…The extrusion of contents also may lead to implant failure. 3 Conventional rigid implants, although not easily deformed, are difficult to fit in the thoracic cavity during surgery. In addition, most of the implants are too heavy.…”

Section: E136mentioning

confidence: 99%

Correction of postpneumonectomy syndrome with tridimensional carbon fiber–printed implant

Wang

Tan

2018

The Journal of Thoracic and Cardiovascular Surgery

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Video clip is available online. An 18-year-old woman presented with a more than 6-month history of recurrent dyspnea, wheezing, recurring right bronchopneumonia, and tachycardia after left pneumonectomy 2 years previously for an adenoid cystic carcinoma of the left main-stem bronchus. Thoracic computed tomography revealed a shift of mediastinal contents and parts of the right lung into the left hemithorax (Figure 1, A and B). The heart abutted the left lateral rib cage, and the vena From the

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Correction of a postpneumonectomy syndrome with congenital pectus excavatum using Ravitch’s procedure and silicone breast implants. Report of a case

Essaleh

Stanzel

Welter

2020

International Journal of Surgery Case Reports

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Correction of postpneumonectomy syndrome using a custom implant

Cited by 5 publications

References 6 publications

Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options

Post-pneumonectomy syndrome: a systematic review of the current evidence and treatment options

Correction of postpneumonectomy syndrome with tridimensional carbon fiber–printed implant

Correction of a postpneumonectomy syndrome with congenital pectus excavatum using Ravitch’s procedure and silicone breast implants. Report of a case

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