胸壁大块切除与重建方法的探讨  

Exploration on the reliable reconstruction methods after massive resection of chest wall

作　　者：舒骏[1] 薛洋[1] 丛伟[1] 陈凡[1] 甘崇志[1] 谢家勇[1] 曾富春[1] 

机构地区：[1]四川省医学科学院.四川省人民医院心胸外科,四川成都610072

出　　处：《四川医学》2012年第10期1698-1700,共3页Sichuan Medical Journal

摘　　要：目的探讨胸壁大块切除及胸壁缺损修补重建的方法和效果。方法回顾性分析11例原发性胸壁肿瘤和其他病变累及胸壁需行胸壁大块切除,术中应用多种方法进行重建。骨性胸廓重建采用戈尔补片及网状钛合金板等人工材料进行修复,皮下软组织修复主要应用分层直接缝合或转移肌皮瓣。结果切除胸壁最大面积(15×20)cm2,原发性胸壁肿瘤5例(良性1例,恶性4例),胸壁结核2例,周围型肺癌3例,乳癌术后复发1例。所有患者均行胸壁大块切除及重建手术。全组无手术死亡,术后呼吸功能良好,无反常呼吸运动。结论依据胸壁缺损的位置和大小,选用不同的修复材料,结合自体肌瓣覆盖是修补重建胸壁的可靠方法。Objective To investigate the methods and efficacy of massive resection and reconstruction of chest wall.Methods 11 cases including primary chest wall tumors and other lesions involving massive resection of chest wall were analyzed retrospectively.Various reconstruction methods were used intraoperative.We used bony thorax with artificial material such as gore patches and mesh titanium alloy plate in reconstruction of chest wall.And the reparation of subcutaneous soft tissue layers were with direct layer suture or muscle flap transfer.Results The maximum recession area of chest wall was 15cm× 20cm.Five patients were diagnosed with primary chest wall tumor（one case of benign and the other four were malignant）,two with chest wall tuberculosis,three with peripheral lung cancer,one with breast cancer recurrence.They all underwent massive resection and reconstruction of chest wall.There was no operative mortality.The postoperative respiratory function of all patients was well,without abnormal respiratory movement.Conclusion It would be a reliable reconstruction method that combining autologous muscle flap coverage and various repair materials based on the location and size of the defect of chest wall.

关 键 词：胸壁病变(原发和继发) 手术治疗 胸壁重建 

分 类 号：R6551.1[医药卫生—外科学]