A Twelve-Year Consecutive Case Experience in Thoracic Reconstruction

نویسندگان

  • Jenny T. Chen
  • Laura A. Bonneau
  • Tracey L. Weigel
  • James D. Maloney
  • Francisco Castro
  • Nikita Shulzhenko
  • Michael L. Bentz
چکیده

BACKGROUND We describe the second largest contemporary series of flaps used in thoracic reconstruction. METHODS A retrospective review of patients undergoing thoracomyoplasty from 2001 to 2013 was conducted. Ninety-one consecutive patients were identified. RESULTS Thoracomyoplasty was performed for 67 patients with intrathoracic indications and 24 patients with chest wall defects. Malignancy and infection were the most common indications for reconstruction (P < 0.01). The latissimus dorsi (LD), pectoralis major, and serratus anterior muscle flaps remained the workhorses of reconstruction (LD and pectoralis major: 64% flaps in chest wall reconstruction; LD and serratus anterior: 85% of flaps in intrathoracic indication). Only 12% of patients required mesh. Only 6% of patients with <2 ribs resected required mesh when compared with 24% with 3-4 ribs, and 100% with 5 or more ribs resected (P < 0.01). Increased rib resections required in chest wall reconstruction resulted in a longer hospital stay (P < 0.01). Total comorbidities and complications were related to length of stay only in intrathoracic indication (P < 0.01). Average intubation time was significantly higher in patients undergoing intrathoracic indication (5.51 days) than chest wall reconstruction (0.04 days), P < 0.05. Average hospital stay was significantly higher in patients undergoing intrathoracic indication (23 days) than chest wall reconstruction (12 days), P < 0.05. One-year survival was most poor for intrathoracic indication (59%) versus chest wall reconstruction (83%), P = 0.0048. CONCLUSION Thoracic reconstruction remains a safe and successful intervention that reliably treats complex and challenging problems, allowing more complex thoracic surgery problems to be salvaged.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Reconstruction of Large Airways Following Main Bronchial Rapture a Year after Blunt Trauma

We present the case of a 19-year-old boy with a history of breathlessness and blunt chest trauma one year ago. Figure 1 show CT scan of patient. Figure 2: show bronchoscopic of patient. Figure 3 and 4 show intra operative view and Fig 5 show CXR of patient after surgery

متن کامل

Localized Lymphomas Presenting in the Chest Wall: A Rare Case Report

A 35-year-old male presented with a history of chest wall pain and swelling. It was decided to perform a CT-scan of the thorax that revealed of a rib involvement in the right hemithorax (Fig 1). We evaluated the yield of core needle biopsy in patients that the was diagnosed lymphoproliferative disorder. Investigation abdominal and pelvic CT scan and blood tests were found no other lesions. The ...

متن کامل

BULL ET-INDUCED FALSE ANEURYSM OF THORACIC AORTA WITH A TEN YEAR LATENCY PERIOD IN A VICTIM OF THE IRAN-IRAQ WAR: REPORT OF A CASE

Traumatic false aneurysm of the thoracic aorta is not uncommon. But accordingly this case is unusual in its ten year delay between injury and presentation and treatment. A victim of the Iran-Iraq war is presented with a false aneurysm of the thoracic aorta ten years after a bullet injury to the chest and thoracic spine. Penetrating chest wounds, mechanisms of injury and diagnosis are also ...

متن کامل

Assessment of Non-Physical Vulnerability at the Neighborhood Scale after Post-Earthquake Reconstruction Experience with a Qualitative Approach (Case study: Qodqoon neighborhood in Boroujerd)

Background and objective: The process of post-disaster reconstruction in developing societies has a high tendency for micro-scale physical renovation. This tendency, that ignore the non-physical issues, originate from the lack of large-scale planning expertise, the lack of social participation mechanisms and the political considerations that govern these countries that do not reduce vulnerabili...

متن کامل

First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review

Pectus excavatum is the most common congenital deformity of the chest wall. The most frequently used techniques include Ravitch (costochondral resection) and Nuss (minimally invasive pectus repair of pectus excavatum [MIRPE]). The Nuss technique includes using temporary metallic bars without costochondral resection to correct the chest wall deformity. Modified MIRPE can be learned easily and pe...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 4  شماره 

صفحات  -

تاریخ انتشار 2016