Correction of postpneumonectomy syndrome with tridimensional carbon fiber–printed implant

Wang, Bin; Tan, Sichuang; Yu, Fenglei

doi:10.1016/j.jtcvs.2017.11.081

Cited by 7 publications

(5 citation statements)

References 4 publications

(3 reference statements)

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“…Saline-filled tissue expanders were used either alone or in combination with fixed-volume prostheses in 28 patients (32.2%), allowing percutaneous volume adjustment. Wang et al described the use of a 3D carbon fibre-printed implant with good results [ 5 ]. Sizing of prostheses was reported in 18 studies with perioperative CVP monitoring (n = 7) and bronchoscopic assessment of airway compression (n = 8) being the most common approaches.…”

Section: Resultsmentioning

confidence: 99%

“…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 ]. In cases where patients develop severe airway malacia following mediastinal repositioning, airway stenting may relieve symptoms, as described by Kelly et al [ 11 ].…”

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%

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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“…Previous studies have reported several articles on the treatment of PPS, including tissue expander implantation [ 3 – 6 ], gas injection [ 7 , 8 ] and stenting [ 9 ]. Unfortunately, tissue expanders for thoracic cavity stabilization are not approved for use in Japan due to insurance regulations, which limits their availability for emergency surgery.…”

Section: Discussionmentioning

confidence: 99%

SF6 is a useful expander for post-pneumonectomy syndrome in the long-term course: a case report

Maeda,

Imamura,

Tabata

et al. 2024

surg case rep

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Background Post-pneumonectomy syndrome (PPS) is a rare but serious condition that can occur after pneumonectomy. It is characterized by a mediastinal shift towards the vacated hemithorax, which can potentially lead to respiratory failure. The management of PPS poses a clinical challenge, especially in the context of the limited availability of certain therapeutic devices due to regulatory restrictions in Japan. Case presentation A 36-year-old female with stage IB non-small cell lung cancer underwent left pneumonectomy. Approximately 2 years later, she developed dyspnea. After consulting with our hospital, subsequent imaging revealed an extreme mediastinal shift causing bronchial obstruction. Emergency thoracotomy and subsequent sulfur hexafluoride (SF6) injections were successfully used to manage her condition. Over the course of follow-up, the interval between SF6 injections was extended from 3 to 11 months, indicating an improvement in the intrathoracic condition. Conclusions This case illustrates the efficacy of SF6 gas in treating PPS and in reducing the frequency of medical interventions. SF6 gas administration is safe and effective for the treatment of patients with PPS.

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“…Patch floating would have occurred if we had performed trachea repair with an autologous pericardial patch alone because of the large-sized defect, and tracheal stenosis and obstruction can easily occur in the late postoperative period. Therefore, combining the results of Aria's study with our own experience with 3D carbon fiber reconstruction implants (6)(7)(8), we designed a customized 3D carbon fiber stent outside the pericardial patch. The floating of the patch and tracheal stenosis were avoided by applying stent traction.…”

Section: Discussionmentioning

confidence: 99%

Trachea repair using an autologous pericardial patch combined with a 3D carbon fiber stent: A case report

Wang

Zhang²,

Guo³

et al. 2023

Front. Surg.

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This study is the first to use an autologous pericardial patch combined with a 3D carbon fiber stent for the plastic repair of a large trachea defect. Radical surgery is the optimal therapy for primary malignant tracheal tumors. Tracheoplasty or repair is required to guarantee trachea integrity and normal ventilation function after tracheal tumor resection. Here, we present a case of plastic repair of the trachea using an autologous pericardial patch and a 3D custom-made carbon fiber stent. A 4 cm trachea defect was successfully repaired after resecting a malignant schwannoma. The postoperative ventilatory function was normal without obvious symptoms of discomfort. Fiberoptic bronchoscopy showed a smooth mucosal surface of the endotracheal wall and patency of the airway. CT scans performed 3 years after surgery showed no recurrence. Therefore, we can conclude that a 3D carbon fiber stent is feasible for abolishing patch floating and preventing tracheal stenosis.

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Correction of postpneumonectomy syndrome with tridimensional carbon fiber–printed implant

Cited by 7 publications

References 4 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

SF6 is a useful expander for post-pneumonectomy syndrome in the long-term course: a case report

Trachea repair using an autologous pericardial patch combined with a 3D carbon fiber stent: A case report

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