个性化3D打印植入物治疗广泛性胸壁肿瘤:临床案例

Ансар Хаматович Валиев, П.В. Кононец, Т.К. Харатишвили, А.Г. Сальков, Н.С. Петроченко, А.Р. Шин, А.В. Сытов, О. Ефименко, A. Valiev, P. Kononets, T. Kharatishvili, A. Salkov, N. S. Petrochenko, A. Shin, A. Sytov, O. Efimenko
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引用次数: 0

摘要

3D打印为恶性肿瘤根治性手术后广泛胸壁缺损的个性化修复系统的发展开辟了新的机会。然而,这种手术的不良后果的风险因素尚未查明。临床病例。一名65岁男性,患有原发性V肋骨软骨肉瘤,手术切除了三根肋骨,局部组织成形术,并在胸骨和IV-VI肋骨上安装了单独的3D打印钛植入物。随访26个月,无复发症状。一名52岁的女性,因乳腺癌放射治疗9年后出现胸壁软组织肉瘤,切除了四根肋骨和胸肌,并在胸骨和II-V肋骨上安装了3D打印的钛植入物。由于软组织瓣边缘坏死及假体感染,手术较为复杂,需拆除金属结构,采用TRAM瓣重建。9个月后,肿瘤局部复发。讨论。作为一个积极结果的因素,应该注意到一层厚厚的皮下脂肪和肌肉组织,由于整形手术进行,覆盖缺陷没有张力。一名女性胸肌的大面积切除造成了组织缺损。另一个不利结果的因素可以被认为是肉瘤的放射诱导性质。对于胸壁恶性肿瘤患者选择义肢的策略有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Personalized 3D printed implants in the treatment of extensive chest wall tumors: clinical cases
3D printing has opened new opportunities for the development of personalized systems for prosthetics of extensive chest wall defects after radical surgical interventions for malignant tumors. However, risk factors for an adverse outcome of such operations have not yet been identified.Clinical cases. A 65-year-old man with primary chondrosarcoma of the V rib, underwent surgical resection of three ribs, plasty with local tissues, and an individual 3D printed titanium implant was installed on the sternum and IV-VI ribs. Follow up for 26 months showed no complaints or signs of recurrence. A 52-year-old woman with radiation-induced soft tissue sarcoma of the chest wall, that developed 9 years after radiation for breast cancer, underwent resection of four ribs and pectoral muscles and a 3D printed titanium implant was installed on the sternum and II-V ribs. The operation was complicated by the marginal necrosis of the soft tissue flap and infection of the endoprosthesis, which required removal of the metal structure and reconstruction using TRAM flap. After 9 months, a local recurrence of the tumor was diagnosed. Discussion. As a factor of a positive outcome in a man should be noted a thick layer of subcutaneous fat with muscle tissue, due to which plastic surgery was performed, covering the defect without tension. An extensive resection of the pectoral muscles in a woman created a tissue deficit. Another factor of an unfavorable outcome can be considered the radio-induced nature of the sarcoma. Further research is needed to improve the strategy for selecting patients with malignant tumors of the chest wall for prosthetics.
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