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Porcine dermal collagen (permacol) for sternal reconstruction.

Lee KH, Kim KT, Son HS, Jung JS, Cho JH - Korean J Thorac Cardiovasc Surg (2013)

Bottom Line: In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity.The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles.Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Korea.

ABSTRACT
In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity. We report a case of a 63-year-old male with a large invasive thymic carcinoma in the anterior mediastinum. The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles. The patient underwent subtotal sternectomy, radical thymectomy, and reconstruction with biological mesh (Permacol). Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.

No MeSH data available.


Related in: MedlinePlus

Specimen consists of sternum, rib, sternal mass and wedge resected lung.
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Figure 3: Specimen consists of sternum, rib, sternal mass and wedge resected lung.

Mentions: After general anesthesia, a single-lumen endotracheal tube was inserted and the operation proceeded in the supine position. After a median skin incision, the mass invading the chest wall was observed. Thus, undermining of both subcutaneous layers and muscle layers was performed in order to determine the invasion range. In addition, extensive resection procuring the tumor margin was performed at the sternal body and 2nd through 5th intercostal rib cartilages using an oscillating saw and rib cutter (Fig. 2). The tumor not only had invaded the sternum and both chest walls, but had also invaded the left jugular vein and the brachiocephalic vein, which were shrunken due to the tumor and had adhered to the left upper lobe. Hence, after saving and detachment of the left phrenic nerve, division at the superior vena cava-innominate vein junction and left jugular vein proximal area was performed by vascular endo-GIA. Despite the obstruction of the innominate vein and left jugular vein, symptoms such as left arm and facial swelling did not appear preoperatively. Therefore, only vascular resection without reconstruction was done, and no such symptoms were noted postoperatively. Tumor invasion to both lungs was also found. Therefore, both pleurae were opened, and wedge resections of the right and left upper lobes were performed using GIA staplers. Since the tumor was also abutting the aortic arch, the parietal pericardium was opened and the tumor was cautiously detached and removed from the aortic wall (Fig. 3).


Porcine dermal collagen (permacol) for sternal reconstruction.

Lee KH, Kim KT, Son HS, Jung JS, Cho JH - Korean J Thorac Cardiovasc Surg (2013)

Specimen consists of sternum, rib, sternal mass and wedge resected lung.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756168&req=5

Figure 3: Specimen consists of sternum, rib, sternal mass and wedge resected lung.
Mentions: After general anesthesia, a single-lumen endotracheal tube was inserted and the operation proceeded in the supine position. After a median skin incision, the mass invading the chest wall was observed. Thus, undermining of both subcutaneous layers and muscle layers was performed in order to determine the invasion range. In addition, extensive resection procuring the tumor margin was performed at the sternal body and 2nd through 5th intercostal rib cartilages using an oscillating saw and rib cutter (Fig. 2). The tumor not only had invaded the sternum and both chest walls, but had also invaded the left jugular vein and the brachiocephalic vein, which were shrunken due to the tumor and had adhered to the left upper lobe. Hence, after saving and detachment of the left phrenic nerve, division at the superior vena cava-innominate vein junction and left jugular vein proximal area was performed by vascular endo-GIA. Despite the obstruction of the innominate vein and left jugular vein, symptoms such as left arm and facial swelling did not appear preoperatively. Therefore, only vascular resection without reconstruction was done, and no such symptoms were noted postoperatively. Tumor invasion to both lungs was also found. Therefore, both pleurae were opened, and wedge resections of the right and left upper lobes were performed using GIA staplers. Since the tumor was also abutting the aortic arch, the parietal pericardium was opened and the tumor was cautiously detached and removed from the aortic wall (Fig. 3).

Bottom Line: In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity.The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles.Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Korea.

ABSTRACT
In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity. We report a case of a 63-year-old male with a large invasive thymic carcinoma in the anterior mediastinum. The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles. The patient underwent subtotal sternectomy, radical thymectomy, and reconstruction with biological mesh (Permacol). Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.

No MeSH data available.


Related in: MedlinePlus