Dataset Information

Thoracic Wall Reconstruction in Advanced Breast Tumours.

ABSTRACT: In advanced mammary tumours, extensive resections, sometimes involving sections of the thoracic wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large thoracic wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of thoracic wall resection on the respiratory mechanism can be easily compensated for and patients' quality of life in the palliative stage of disease can often be improved.

SUBMITTER: Daigeler A

PROVIDER: S-EPMC4069213 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

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Thoracic Wall Reconstruction in Advanced Breast Tumours.

Daigeler A A Harati K K Goertz O O Hirsch T T Behr B B Lehnhardt M M Kolbenschlag J J

Geburtshilfe und Frauenheilkunde 20140601 6

In advanced mammary tumours, extensive resections, sometimes involving sections of the thoracic wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large thoracic wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of thoracic wall resection on the respiratory mechanism ...[more]

PMID: 24976636

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Project description:Chest wall tumors are a relatively uncommon disease in clinical practice. Most of the published studies about chest wall tumors are usually single-center retrospective studies, involving few patients. Therefore, evidences regarding clinical conclusions about chest wall tumors are lacking, and some controversial issues have still to be agreed upon. In January 2019, 73 experts in thoracic surgery, plastic surgery, science, and engineering jointly released the Chinese Expert Consensus on Chest Wall Tumor Resection and Chest Wall Reconstruction (2018 edition). After that, numerous experts put forward new perspectives on some academic issues in this version of the consensus, pointing out the necessity to further discuss the points of contention. Thus, we conducted a survey through the administration of a questionnaire among 85 experts in the world. Consensus has been reached on some major points as follows. (I) Wide excision should be performed for desmoid tumor (DT) of chest wall. After excluding the distant metastasis by multi-disciplinary team, solitary sternal plasmacytoma can be treated with extensive resection and adjuvant radiotherapy. (II) Wide excision with above 2 cm margin distance should be attempted to obtain R0 resection margin for chest wall tumor unless the tumor involves vital organs or structures, including the great vessels, heart, trachea, joints, and spine. (III) For patients with chest wall tumors undergoing unplanned excision (UE) for the first time, it is necessary to carry out wide excision as soon as possible within 1-3 months following the previous surgery. (IV) Current Tumor Node Metastasis staging criteria (American Joint Committee on Cancer) of bone tumor and soft tissue sarcoma are not suitable for chest wall sarcomas. (V) It is necessary to use rigid implants for chest wall reconstruction once the maximum diameter of the chest wall defect exceeds 5 cm in adults and adolescents. (VI) For non-small cell lung cancer (NSCLC) invading the chest wall, wide excision with neoadjuvant and/or adjuvant therapy are recommended for patients with stage T3-4N0-1M0. As clear guidelines are lacking, these consensus statements on controversial issues on chest wall tumors and resection could possibly serve as further guidance in clinical practice during the upcoming years.

Project description:BACKGROUND:Surgery remains the main curative option for the treatment of intraspinal tumour. The purpose of the present study was to analyze the clinical outcomes of laminoplasty with process-lamina complex replantation compared with laminectomy with pedicle screw fixation for intraspinal tumours. METHODS:In our retrospective analysis, 27 patients received tumour resection surgery by laminoplasty with reconstruction plate fixation and 32 patients received laminectomy with pedicle screw fixation. All patients were followed up for at least 1?year. Data, including surgical time, blood loss, volume of drainage, drainage time, hospital stay, complications, and neurological status were compared. In addition, imaging evaluation was also included. RESULTS:Patients in the laminoplasty group had lower blood loss (laminoplasty group: 281.5?±?130.2?mL; laminectomy group: 450.0?±?224.3?mL; p =?0.001), shorter surgical time (laminoplasty group: 141.7?± 26.2?min, laminectomy group: 175.3?± 50.4?min; p =?0.003), lower volume of drainage (laminoplasty group: 1578.9?±?821.7?mL, laminectomy group: 2621.2?±?1351.0?mL; p =?0.001), shorter drainage time (laminoplasty group: 6.6?±?2.5?days, laminectomy group: 9.7?±?1.8?days; p =?0.000), and a shorter hospital stay (laminoplasty group: 16.9?±?4.9?days, laminectomy group: 21.0?±?4.4?days; p =?0.002) compared with patients in the laminectomy group. There were significant differences of oswestry dysfunction index (ODI) between the two groups at 12?months postoperatively (p =?0.034). The incidence of secondary spinal stenosis in the laminoplasty group was significantly reduced (p =?0.029). CONCLUSIONS:Laminoplasty in intraspinal tumour resection has a lower blood loss and volume of drainage, shorter surgical time and hospital stay as advantages over the standard laminectomy technique. Moreover, laminoplasty can effectively avoid iatrogenic spinal canal stenosis and thus enhancing functional recovery of spinal cord.

Dataset Information

Thoracic Wall Reconstruction in Advanced Breast Tumours.

Publications

Thoracic Wall Reconstruction in Advanced Breast Tumours.

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