Three-Dimensional Printed Models for Preoperative Planning and Surgical Treatment of Chest Wall Disease: A Systematic Review

Abstract

Introduction: In chest wall reconstruction, the main objectives are the restoration of the chest wall integrity, function, and aesthetic, which is often achieved with the placement of implants. We aimed to evaluate whether 3D printed models can be useful for preoperative planning and surgical treatment in chest wall reconstruction to improve the outcome of the surgery and to reduce the rate of complications. Methods: We conducted a systematic review of literature using PubMed, Scopus, Embase, and Google Scholar databases until 8 November 2021 with the following keywords: (“3D printing” or “rapid prototyping” or “three-dimensional printing” or “bioprinting”) and (“chest wall” or “rib” or “sternum” or “ribcage” or “pectus excavatum”). Results were then manually screened by two independent authors to select studies relevant to 3D printing application in chest wall reconstruction. The primary outcome was morphological correction, and secondary outcomes were changes in operating time and procedure-related complication rate. Results: Eight articles were included in our review. Four studies were related to pectus excavatum correction, two studies were related to rib fracture stabilization, and two studies were related to chest wall tumor resection and reconstruction. Seven studies reported 3D printing of a thorax model or template implants for preoperative planning and implant modeling, and one study reported 3D printing of a PEEK prosthesis for direct implantation. Four studies reported comparison with a conventionally treated control group, and three of them detected a shorter operative time in the 3D printing model-assisted group. Satisfactory morphological correction was reported in all studies, and six studies reported a good implant fitting with minimal need for intraoperative adjustments. There were no major intraoperative or postoperative complications in any of the studies. Conclusions: The use of 3D printing models in chest wall reconstruction seems to be helpful for the production of personalized implants, reducing intraoperative adjustments. Results of morphological correction and postoperative recovery after the 3D printing-assisted surgery were satisfactory in all studies with a low rate of complication. Our literature review suggests good results regarding prosthesis fitting, accuracy of surgical planning, and reduction in operative time in 3D printing-assisted procedures, although more evidence is needed to prove this observation.

Personalized 3D printed implants in the treatment of extensive chest wall tumors: clinical cases

“…Из-за отсутствия в настоящее время клинических рекомендаций по выбору варианта реконструкции способ замещения определяется в каждом центре индивидуально [10]. При изготовлении индивидуального импланта в большинстве случаев используется титановый сплав, который ввиду высокой прочности и ригидности обеспечивает надлежащий уровень каркасности грудной стенки и не нарушает биомеханику дыхания [6,9,10].…”

“…Резекции ребер и грудины по поводу их злокачественных опухолей требуют замещения дефектов. В мировой литературе первые упоминания о замещении дефектов грудной стенки различными синтетическими и алломатериалами датируются серединой XX в. Описаны случаи использования аутотрансплантатов костей, пластин из синтетических материалов, различные комбинаций подобных имплантов [5,6].…”

“…Новые перспективы открыло применение индивидуальных систем протезирования дефектов грудной стенки, изготовленных с помощью аддитивных технологий -3D-принтинга -на основании антропометрических характеристик пациента [6][7][8]. Внедрение подобного индивидуализированного подхода в первую очередь позволяет решить ключевую проблему всех предшествующих вариантов реконструкции грудной стенки -печать выполняется на основании данных конкретного пациента, что позволяет эффективно заместить дефект.…”

Advancements in preoperative imaging of pectus excavatum: a comprehensive review

“…Surgeons may devise surgical strategies based upon CT-derived three-dimensional (3D) reconstruction of the thoracic wall ( 20 ). Other emerging techniques to aid in the decision process are 3D printing (additive manufacturing) of thoracic models and bar templates, or virtual simulations of the Nuss procedure ( 21 - 29 ). Preoperative planning using CT scans allows to create personalized pectus bars preoperatively for more effective corrections of the deformity and to eliminate intraoperative revisions of the bar shape.…”

Classification of the Volume of Tumor Lesion of the Chest Wall as A Prerequisite for Planning Surgical Treatment

“…Несмотря на успехи лекарственной терапии, радикальное хирургическое вмешательство является залогом успешного лечения пациентов со злокачественными опухолями грудной стенки [31,[34][35][36]39]. При этом одним из наиболее важных прогностических факторов служит достаточный отступ при резекции грудной стенки.…”