Resection of Sternal Tumors and Reconstruction of the Thorax: A Review of 15 Patients

Haraguchi, Shuji; Hioki, Masafumi; Hisayoshi, Takao; Yamashita, Koji; Yamashita, Yasuo; Kawamura, Jun; Hirata, Tomomi; Yamagishi, Shigeki; Koizumi, Kiyoshi; Shimizu, Kazuo

doi:10.1007/s00595-005-3134-0

Cited by 33 publications

(20 citation statements)

References 22 publications

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“…The conventional operative techniques in the similar chest wall reconstructions are based on using sandwiched Marlex and stainless-steel mesh with metacylate as a material for the reconstruction [15,16], free and pedicled bone grafts (ribs), periosteal flaps, strips of fascia lata, fascia lata flaps and pedicled muscle flaps [17], polypropylene mesh-resin sandwich [18,19], or titanium micromesh covered with Marlex mesh [20]. In these cases, the prostheses are shaped by hand during the operation without taking into account the geometry that preceded the illness.…”

Section: Resultsmentioning

confidence: 99%

Reverse modeling and solid free-form fabrication of sternum implant

Stojković

Milovanović

Vitković

et al. 2010

Australas Phys Eng Sci Med

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The paper presents a case where an implant for a part of the sternum (with costal cartilages) affected by cancer was created and implanted by using the specific reverse modeling method and solid free-form fabrication. The method provides surgeons with a fast and reliable tool for tissue engineering and implantation and therefore improves the quality of life for patients. Digital images of healthy sternum samples were used to develop a reverse modeling algorithm that semi-automatically generates a necessary and sufficient simplification of the tissue geometry to be fabricated in an inexpensive and applicable manner. In this particular case, the redesign of the missing part of the sternum in CAD software took three designer-hours. At the same time, the suitable simplification of the geometry affects the fabrication of simpler and less expensive casting molds. Furthermore, the core of the developed algorithm for the reverse modeling of sternum can be applied in the reverse modeling improvement of other tile (or plate-like) bones.

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Section: Resultsmentioning

confidence: 99%

Reverse modeling and solid free-form fabrication of sternum implant

Stojković

Milovanović

Vitković

et al. 2010

Australas Phys Eng Sci Med

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show abstract

“…Polypropylene mesh (Marlex mesh,R) is used most frequently for the reconstruction of chest wall defects. Although this mesh is relatively easy to handle and has a high affinity for tissues [27], its lack of rigidity in patients with large defects may result in paradoxical chest wall motion [28]. In contrast, methyl methacrylate and titanium plates are highly rigid but insufficiently malleable.…”

Section: Discussionmentioning

confidence: 99%

Chondrosarcoma from the sternum: Reconstruction with titanium mesh and a transverse rectus abdominis myocutaneous flap after subtotal sternal excision

et al. 2012

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SummaryBackgroundChondrosarcoma arising from the sternum is extremely rare and is often untreatable. Removal of the sternum for malignant tumor results in large defects in bone and soft tissue, causing deformity and paradoxical movement of the chest wall and making subsequent repair of the thorax very important. We report a very rare patient with a chondrosarcoma of the sternum who underwent case chest wall resection, followed by reconstruction using a titanium mesh covered with a transverse rectus abdominis myocutaneous (TRAM) flap.Case ReportA 63-year-old man was referred to our hospital with progressively enlarged swelling of his anterior chest wall. Physical examination showed a 2.5×2.0 cm mass fixed to the sternum, which was diagnosed as a chondrosarcoma based on clinical findings, imaging characteristics and incision biopsy results. The patient underwent a subtotal sternal and chest wall resection to remove the tumor, followed by reconstruction with a titanium mesh and a TRAM flap. There were no complications associated with surgery.ConclusionsWe report an extremely rare case of a patient who underwent subtotal sternal resection, followed by reconstruction, for a large chondrosarcoma. The elasticity and rigidity provided by the titanium mesh and the complete coverage of the surgical wound by a TRAM flap suggest that these procedures may be useful in reconstructing large defects in the chest wall.

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“…However, their rigidity is insufficient to protect intrathoracic organs. Various prostheses have been used, with sufficient rigidity, such as sandwiched polypropylene mesh and stainless steel mesh [3], methyl methacrylate sandwiched between polypropylene mesh [4], titanium plate-supported methyl methacrylate sandwich [5], titanium plate with Gore-Tex ® dual mesh [6], and Composix Mesh ™ [7]. However, methyl methacrylate is not easy to handle and is difficult to adapt to the shape of the patient’s chest.…”

Section: Discussionmentioning

confidence: 99%

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

Matsumoto

Sano

Nakamura

et al. 2012

Gen Thorac Cardiovasc Surg

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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.

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Resection of Sternal Tumors and Reconstruction of the Thorax: A Review of 15 Patients

Abstract: Wide resection of sternal tumors provides good local control. Reconstruction with Marlex and stainless-steel mesh seems to be the most effective technique for repairing a wide anterior chest wall defect.

Cited by 33 publications

References 22 publications

Reverse modeling and solid free-form fabrication of sternum implant

Reverse modeling and solid free-form fabrication of sternum implant

Chondrosarcoma from the sternum: Reconstruction with titanium mesh and a transverse rectus abdominis myocutaneous flap after subtotal sternal excision

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

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