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目的 观察胸壁肿瘤切除术后胸壁缺损一期修复重建的临床效果。 方法 1998年1月～2 0 0 3年3月外科治疗胸壁肿瘤31例。男2 0例,女11例。年龄8～72岁。原发性胸壁肿瘤2 1例,肺癌侵犯胸壁6例,乳腺癌术后复发2例,放射性坏死和皮肤癌各1例。切除肋骨2～7根,平均3.6根。缺损面积2 0～2 2 0 cm2 ,平均97.1cm2 。合并肺切除10例,部分膈肌切除2例,胸骨下段切除1例。单纯软组织修复7例(背阔肌+大网膜,背阔肌肌皮瓣,背阔肌肌瓣) ,单纯骨性重建5例(涤纶布或Prolene网) ,骨性合并软组织修复19例(背阔肌、胸大肌、背阔肌+阔筋膜或大网膜,与涤纶布或Prolene网修复)。 结果 术后发生并发症3例( 9.7% ) ,其中切口感染1例,软组织与修复物之间积液2例。无手术死亡。2 6例获5～5 7个月随访,术后生存时间6～5 7个月,中位生存时间2 2个月。 结论 胸壁肿瘤切除术后造成的巨大缺损,采用胸壁修复重建术可获得良好的临床效果
Objective To observe the clinical effect of primary repair and reconstruction of chest wall defect after resection of thoracic wall tumor. Methods Thirty-one cases of thoracic tumors were surgically treated from January 1998 to March 2003. 20 males and 11 females. Age 8 to 72 years old. There were 21 cases of primary chest wall tumor, 6 cases of lung cancer invading chest wall, 2 cases of recurrence of breast cancer, 1 case of radioactive necrosis and 1 case of skin cancer. Excavation of ribs 2 to 7, an average of 3.6 root. Defect area 20 ~ 2 2 0 cm2, an average of 97.1cm2. Pulmonary resection in 10 cases, partial resection of the diaphragm in 2 cases, 1 case of lower sternum resection. Only soft tissue repair in 7 cases (latissimus dorsi + omentum, latissimus dorsi muscle flap, latissimus dorsi muscle flap), simple bone reconstruction in 5 cases (polyester cloth or Prolene mesh), bone combined with soft tissue repair in 19 cases Latissimus dorsi, Pectoralis major, Latissimus dorsi + Fascia or Omental, and Polyester or Prolene mesh repair). Results Postoperative complications occurred in 3 cases (9.7%), including incision infection in 1 case, soft tissue and repair fluid in 2 cases. No surgery died. 26 cases were followed up for 5 ~ 57 months. The postoperative survival time was 6 ~ 57 months and the median survival time was 22 months. Conclusion The huge defect caused by resection of chest wall tumor can achieve good clinical effect by chest wall reconstruction