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[Resection and reconstruction of sternum]
N Katoh1, Y Hatano, S Sasamoto
1Department of Thoracic and Cardiovascular Surgery, School of Medicine, Toho University, Tokyo, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|June 10, 1998
Summary
Surgical reconstruction using rib-latissimus dorsi osteomyocutaneous flaps effectively restores chest wall integrity after sternal resection for breast cancer. This biological reconstruction method avoids complications and supports adjuvant therapies, improving patient survival rates.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Plastic and reconstructive surgery
Context:
- Sternal resection is necessary for locally advanced or recurrent breast cancer.
- Maintaining chest wall stability and thoracic cavity airtightness is crucial post-resection.
- Previous reconstruction methods have had varying success rates.
Purpose:
- To evaluate the efficacy of rib-latissimus dorsi osteomyocutaneous flaps for chest wall reconstruction after sternal resection in breast cancer patients.
- To assess the functional and aesthetic outcomes, as well as complication rates, associated with this reconstructive technique.
Summary:
- Six patients with sternal resection due to breast cancer underwent chest wall reconstruction using either rib-latissimus dorsi osteomyocutaneous flaps or latissimus dorsi myocutaneous flaps.
- Total sternal resection was performed in three cases, reconstructed with rib-latissimus dorsi osteomyocutaneous flaps.
- Biological materials were exclusively used after an early complication with an artificial patch, with subsequent radiotherapy and/or chemotherapy administered without flap-related issues.
Impact:
- The rib-latissimus dorsi osteomyocutaneous flap provides a reliable method for chest wall reconstruction, preserving function and aesthetics.
- This technique facilitates adjuvant therapies like radiotherapy and chemotherapy, crucial for managing recurrent breast cancer.
- The study reports a 2-year survival rate of 50% and a long-term survivor of 10 years, indicating improved outcomes for sternal recurrence of breast cancer.