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Abstract

Objectives: This paper aimed to study the feasibility, the surgical methodology, and technique for reconstruction using allogeneic sternal graft after sternum tumor resection. Materials and Methods: Three patients (2 men and 1 woman, aged 19, 44, and 52) with primary sternum malignant tumor were admitted from January 2008 to December 2010 to the Second Hospital of Shandong University, Jinan, China. We conducted subtotal resection of the sternum and simultaneous reconstruction with allogeneic sternal graft. Allogeneic sternum was frozen beforehand; the scope of removal was 2 cm away from the lesion. Transplanted allogeneic sternum was fixed using steel wire and residual cavity was filled with the greater omentum. Results: Three patients recovered without major complication and were discharged from the hospital with successful operation and satisfactory results. They were followed-up for 6 months to 2 years, no tumor relapse or any obvious rejection were found. Conclusions: The freezing allogeneic sternum can be used as a substitute for reconstruction after sternum tumor resection.

Chest reconstruction using a custom-designed polyethylene 3D implant after resection of the sternal manubrium

“…There are no doubts as to the fact that every malignant tumor, apart from chemosensitive primary microcellular sarcoma (Ewing sarcoma, primary neuroectodermal sarcoma), should be removed entirely, ideally with the margin of 2–5 cm of healthy tissues. 4 The choice of chest reconstruction depends, however, on the size of the defect and operator preferences. Defects of <5 cm diameter do not usually require rigid implant reconstruction.…”

“… 7 In addition, the following are also used: Ley’s prostheses in the form of a titanium plate in the shape of a footprint fixed to the ribs with metal threads, 8 sternum and rib fragments made of titanium in 3D technique, 9 , 10 silicone implants made on the basis of a patient’s chest print before the surgery (in this case, most complications are observed, like recurrent serous exudate up to 31%), 11 autografts of osseous tissue and muscle fragments 6 and allografts of the sternal fragment from deceased donors. 4 Implant should be resistant to forces acting on chest skeleton, plastic so as to adjust it according to the size of the sternum defect, translucent for X-rays 7 and also made of a material which is not a breeding ground for bacterial flora. 3 Polyethylene seems to be a good material for sternal implants because it is rigid and nonabsorbable, and does not react with bones, soft tissues or body liquids.…”

Surgical treatment of tumours of the sternum – 10 years’ experience

“…The resection margin has been discussed in the literature since the extent of resection is associated with radical resection [ 11 ]. Most suggest a 4–5 margin, or simply negativity in a frozen section without a specific distance was safe enough [ 12 ].…”

“…After manubrium resection, a muscle flap is recommended and rigid reconstruction after lower sternal resection to protect the heart and stabilise the thorax [ 6 ]. Omental flaps are used for infected sternal wounds and filling residual cavities [ 12 ].…”