Anterior chest wall resection and reconstruction for locally advanced breast cancer.

Autor: Wee HE; Department of Thoracic Surgery, Tan Tock Seng Hospital, Singapore hide.wee@mohh.com.sg., Akbar FA; Department of Thoracic Surgery, Tan Tock Seng Hospital, Singapore., Rajapaksha K; Department of Thoracic Surgery, Tan Tock Seng Hospital, Singapore., Aneez DB; Department of Thoracic Surgery, Tan Tock Seng Hospital, Singapore.
Jazyk: angličtina
Zdroj: Multimedia manual of cardiothoracic surgery : MMCTS [Multimed Man Cardiothorac Surg] 2015 Sep 11; Vol. 2015. Date of Electronic Publication: 2015 Sep 11 (Print Publication: 2015).
DOI: 10.1093/mmcts/mmv025
Abstrakt: With breast cancer awareness, the incidence of large invasive tumours is rare. We present a video of locally advanced breast cancer invading the anterior chest wall requiring en bloc resection that resulted in a large chest wall defect with exposed pleural and pericardial surface. Skeletal reconstruction and provision of adequate soft tissue coverage in order to avoid respiratory failure was challenging. A 58-year-old female presented with a 3-year history of locally invasive breast carcinoma with contiguous spread to sternum, clavicles, sternoclavicular joints and bilateral second to fifth ribs. She underwent total sternectomy, bilateral second to fifth ribs and chest wall resection resulting in a 21 × 18 cm chest wall defect. Reconstruction of her sternum was with methyl-methacrylate cement prosthesis. Ribs were reconstructed with titanium plates. Soft tissue coverage was achieved with left vertical rectus abdominis pedicle flap, right external oblique transposition flap and a right latissimus dorsi free flap. Flap failure necessitated a right vastus lateralis free flap. She was discharged ambulant without respiratory compromise. Resection and reconstruction of large chest wall defects is possible due to new bioprosthetic materials and is possible with acceptable morbidity and mortality.
(© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: