Turkiye Klinikleri Archives of Lung

.: ORIGINAL RESEARCH
Prolen Meş ve Metilmetakrilattan Oluşan Sandviç Greft ile Göğüs Duvarı Rekonstrüksiyonu: 15 Olgunun Analizi
Chest Wall Reconstruction with Methylmethacrylate and Prolene Mesh in the Form of Sandwich Prosthesis: Analysis of 15 Cases
Hıdır ESMEa, Ferdane Melike DURANa
aSağlık Bilimleri Üniversitesi Konya Eğitim ve Araştırma Hastanesi, Göğüs Cerrahi Kliniği, Konya, TÜRKİYE
Turkiye Klinikleri Arch Lung. 2021;20(1):1-5
doi: 10.5336/archlung.2020-74842
Article Language: TR
Full Text
ÖZET
 Amaç: Göğüs duvarının rekonstrüksiyonu büyük rezeksiyonlardan sonra zorunludur. Bu çalışmada, göğüs duvarı rezeksiyonu sonrası prolen meş ve metilmetakrilattan oluşan sandviç greft ile rekonstrüksiyon uyguladığımız hastaların sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntemler: Ocak 2010 ile Aralık 2019 yılları arasında kliniğimizde göğüs duvarı rezeksiyonu ve rekonstrüksiyonu uygulanan 15 hasta geriye dönük olarak incelendi. Hastalar yaş, cinsiyet, tümörün tanısı, defektin büyüklüğü, postoperatif komplikasyonlar, yoğun bakım ve hastane kalış süresi ve postoperatif takip açısından incelendi. Bulgular: Tanı 5 hastada invaziv duktal karsinoma nüksü, 4 hastada kondrosarkoma, 4 hastada küçük hücreli dışı akciğer karsinomunun göğüs duvarına invazyonu, 1 hastada kolon karsinomu metastazı ve diğer 1 hastada osteosarkoma idi. Ortalama rezeke edilen kaburga sayısı 3,63±1,16 (3-5) idi. Kaburga rezeksiyonu dışında, 4 hastada akciğer rezeksiyonu ve 3 hastada parsiyel sternum rezeksiyonu uygulandı. İskelet rekonstrüksiyonuyla birlikte 9 hastada yumuşak doku rekonstrüksiyonu uygulandı. Hastaların 6'sında postoperatif komplikasyon görüldü. Hastanede kalış süresi 7,34±3,13 (6-18) idi. Hastalar ortalama 29±6,5 (10-37) ay takip edildi. Takipte 2 hastada uzak metastaz, 1 hastada lokal rekürrens saptandı. Sonuç: Göğüs duvarı malignitelerine bağlı geniş göğüs duvarı rezeksiyonlarında prolen meş ve metilmetakrilattan oluşan sandviç greft ile rekonstrüksiyon güvenli, ucuz, mortalite ve morbiditesi düşük bir yöntemdir.

Anahtar Kelimeler: Göğüs duvarı tümörü; rekonstrüksiyon; sandviç greft
ABSTRACT
 Objective: Reconstruction of chest wall is mandatory after large excisions. In this article we aimed to evaluate the results of fifteen patients who underwent chest wall resection and reconstruction with methylmethacrylate and prolene mesh in the form of "sandwich" prosthesis. Material and Methods: Fifteen patients were retrospectively reviewed who underwent chest wall resection and reconstruction at our Institute (January 2010 to December 2019). The patients were examined in terms of age, gender, diagnosis of the tumor, size of the defect, postoperative complications, intensive care and hospital stay, and postoperative follow-up. Results: The indications for resection were recurrence of breast cancer in 5 patients, condrosarcoma 4, nonsmall cell lung cancer with invasion of chest wall 4, metastasis of colon carcinoma 1 and osteosarcoma 1. The mean number of rib resected was 3.63±1.16 ribs (3-5). Concomitant resection was done in 7 patients; including lung resection 4 and partial resection of sternum 3. Simultaneous skeletal reconstruction and soft tissue reconstruction were performed in 9 patients. Six patients developed postoperative complications. The mean hospital stay was 7.34±3.13 days (range 6 to 18) days. Follow-up was carried out for a mean period of 29±6.5 months (10-37). Three patients developed relapse, metastases in two cases and local recurrence in one case. Conclusion: Chest wall resection followed by reconstruction utilizing synthetic mesh with a methylmethacrylate and prolene mesh in the form of "sandwich" prosthesis can be performed as a safe, cheap method with low mortality and morbidity.

Keywords: Chest wall tumors, recontruction, sandwich prosthesis
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