Use of titanium ribs plates for reconstruction of large full-thickness thoracic wall defect after a tumor resection

Authors

  • Leonardo Toscano Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Cirugía de Tórax. Asistente
  • Ulises Parada Universidad de la República, Facultad de Medicina, Hospital de Clínicas. Residente de Cirugía
  • Daniel Terra Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Quirúrgica F. Prof. Adjto
  • Siul Salisbury Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Cirugía de Tórax. Prof. Agdo

Keywords:

TITANIUM, THORACIC WALL, THORACIC NEOPLASMS, THORACIC SURGICAL PROCEDURES

Abstract

Reconstruction of full thickness thoracic wall defects remains a controversial topic, with older osteosynthesis materials complication rates ranging from 46 to 69%. Recent introduction of titanium in the making of the plates, makes this material ideal for this type of procedures due to being stainless, chemically inert and the fact that the ribs adapt correctly to the thorax shape.
We present the case of a 56 year old male, with Von Recklinghausen disease in whom we performed a resection of an anteroateral chest wall tumor, which included four costal arches and the corresponding cartilage. Reconstruction with titanum plates and prolene mesh was performed. The patient had no postoperative complications. This ostesynthesis system with titanium plates matrix rib provides both functional, safe and good cosmetic results.

References

(1) Berthet JP, Wihlm JM, Canaud L, Joyeux F, Cosma C, Hireche K, et al. The combination of polytetrafluoroethylene mesh and titanium rib implants: an innovative process for reconstructing large full thickness chest wall defects. Eur J Cardiothorac Surg 2012; 42(3):444-53.
(2) Deschamps C, Tirnaksiz BM, Darbandi R, Trastek VF, Allen MS, Miller DL, et al. Early and long-term results of prosthetic chest wall reconstruction. J Thorac Cardiovasc Surg 1999; 117(3):588-91.
(3) Weyant MJ, Bains MS, Venkatraman E, Downey RJ, Park BJ, Flores RM, et al. Results of chest wall resection and reconstruction with and without rigid prosthesis. Ann Thorac Surg 2006; 81(1):279-85.
(4) Incarbone M, Pastorino U. Surgical treatment of chest wall tumors. World J Surg 2001; 25(2):218-30.
(5) Berthet JP, Canaud L, D’Annoville T, Alric P, Marty-Ane CH. Titanium plates and Dualmesh: a modern combination for reconstructing very large chest wall defects. Ann Thorac Surg 2011; 91(6):1709-16.
(6) Gonfiotti A, Santini PF, Campanacci D, Innocenti M, Ferrarello S, Caldarella A, et al. Malignant primary chest-wall tumours: techniques of reconstruction and survival. Eur J Cardiothorac Surg 2010; 38(1):39-45.
(7) Campbell RM Jr, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, et al. The effect of opening wedge thoracostomy on thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am 2004; 86-A(8):1659-74. 7
(8) Lardinois D, Müller M, Furrer M, Banic A, Gugger M, Krueger T, et al. Functional assessment of chest wall integrity after methylmethacrylate reconstruction. Ann Thorac Surg 2000; 69(3):919-23.
(9) Coonar AS, Wihlm JM, Wells FC, Qureshi N. Intermediate outcome and dynamic computerised tomography after chest wall reconstruction with the STRATOS titanium rib bridge system: video demonstration of preserved bucket-handle rib motion. Interact Cardiovasc Thorac Surg 2011; 12(1):80-1.
(10) Gimferrer JM, Belda J, Catalán M, Callejas MA, Canalis E, Serra M. Experiencia en el tratamiento quirúrgico de los tumores primarios malignos de la pared torácica. Cir Esp 2003; 73(2):110-3.
(11) McCormack PM. Use of prosthetic materials in chest-wall reconstruction: assets and liabilities. Surg Clin North Am 1989; 69(5):965-76.
(12) Berthet JP, D’Annoville T, Canaud L, Marty-Ané CH. Use of the titanium vertical ribs osteosynthesis system for reconstruction of large posterolateral chest wall defect in lung cancer. Interact Cardiovasc Thorac Surg 2011; 13(2):223-5.
(13) Dang NC, Siegel SE, Phillips JD. Malignant chest wall tumors in children and young adults. J Pediatr Surg 1999; 34(12):1773-8.
(14) Mansour KA, Thourani VH, Losken A, Reeves JG, Miller JI Jr, Carlson GW, et al. Chest wall resections and reconstruction: a 25-year experience. Ann Thorac Surg 2002; 73(6):1720-5.
(15) Arnold PG, Pairolero PC. Chest-wall reconstruction: an account of 500 consecutive patients. Plast Reconstr Surg 1996; 98(5):804-10.
(16) Ducatman BS, Scheithauer BW. Malignant peripheral nerve sheath tumors with divergent differentiation. Cancer 1984; 54(6):1049-57.
(17) 17. Guo A, Liu A, Wei L, Song X. Malignant peripheral nerve sheath tumors: differentiation patterns and immunohistochemical features - a mini-review and our new findings. J Cancer 2012; 3:303-9.

Published

2015-09-30

How to Cite

1.
Toscano L, Parada U, Terra D, Salisbury S. Use of titanium ribs plates for reconstruction of large full-thickness thoracic wall defect after a tumor resection. Rev. Méd. Urug. [Internet]. 2015 Sep. 30 [cited 2024 Sep. 7];31(3):203-8. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/206