HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lampl, L. Search for Related Content PubMed PubMed Citation Articles by Lampl, L. Related Collections Chest wall

Eur J Cardiothorac Surg 2001;20:669-673
© 2001 Elsevier Science NL

Chestwall resection: a new and simple method for stabilization of extended defects

I. Chirurgische Klinik, Zentralklinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany

Received 22 November 2000; received in revised form 28 May 2001; accepted 4 July 2001.

Tel.: +49-821-400-2988; fax: +49-821-400-4572
e-mail: dr_ludwig_lampl{at}hotmail.com

Objective: Postresectional chestwall defects can usually be stabilized by reconstructions under tension. Only few extended defects require combined stabilizing methods. The one used mostly is Marlex^®-Sandwich, despite some disadvantages. An alternative method using alloplastic material/metal bar is presented. Material and methods: Between 1986 and 1999, 189 chestwall resections were performed either for infiltrating bronchogenic carcinoma (Type I, n=67), tumors originating from chestwall or bony metastases (Type II, n=88), or local recurrences and infiltration by breast cancer or sequelae of its treatment (Type III, n=34).The standard reconstruction is performed with non-absorbable alloplastic meshes or patches under some degree of tension. For defects exceeding 250 cm², usually Type-II cases, a reconstruction under tension is no longer appropriate. Therefore we developed a procedure which we used in six cases. Alloplastic mesh or patch gets sutured in the same way as is done in smaller defects. Then a metal bar (Grob-Stab^®, Ulrich, Herrlingen/Blaustein, Germany) is threaded through the alloplastic material and is fixed at the adjacent ribs by Parham steel bands (Ethicon, Sommerville, KY, USA). Results: In all cases we achieved excellent stability. All of the patients were extubated on the operating table. There was no morbidity or mortality. In three cases the metal bars were removed after 3, 6 and 16 months postoperatively (dynamization). Conclusion: The new procedure is safe, simple and quickly performed. The additional costs are low (160 euro). The patient's comfort is excellent; borderline problems as described for Marlex^®-Sandwich can be avoided, so that this procedure can be considered as an alternative to Marlex^®-Sandwich.

Key Words: Extended chestwall defect • Combined stabilization

This article has been cited by other articles:

				T. F. Molnar, L. Lukacs, and O. P. Horvath Sternal replacement using composite allograft Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 371 - 372. [Full Text] [PDF]