膨体聚四氟乙烯补片在胸壁重建中的应用

目的分析膨体聚四氟乙烯(Gore-Tex)补片在胸壁重建中的注意事项,总结临床应用经验。方法回顾性分析第二军医大学长海医院2001年1月至2010年l2月期间33例使用Gore-Tex补片进行修复巨大胸壁缺损的临床资料,男19例,女14例;平均年龄45.7(20～73)岁。根据肿瘤位置、大小选择不同的手术切口;术中尽量保留正常的胸壁软组织,骨性胸壁缺损采用Gore-Tex补片进行重建,软组织直接对拢缝合,全层胸壁缺损采用转移肌皮瓣覆盖创面。结果全组33例均手术顺利,围术期无死亡患者;恶性肿瘤25例,良性肿瘤8例,均被完整切除,切除瘤体直径8～20 cm。随访5～60个月,失访3例(9.09%),无排斥反应及反常呼吸,无异物感,感染率3%(1/33)。结论 Gore-Tex补片具有极佳的生物相容性,是安全有效的胸壁重建材料;选择合适的肌皮瓣覆盖补片,能够减少并发症发生。

Application of Gore-Tex Patch in Chest Wall Reconstruction

Objective To summarize the application experience of Gore-Tex patch in clinical chest wall reconstruction.Methods A retrospective analysis was performed in 33 patients who underwent chest wall reconstruction using Gore-Tex patch from January 2001 to December 2010 in Shanghai Changhai Hospital,Second Military Medical University.There were 19 men and 14 women,ranging in age from 20 to 73 years with a median age of 45.7 years.The surgical strategies included choosing different incisions according to tumor location and size,and preserving normal chest wall soft tissue as much as possible during surgery.Gore-Tex patch was used to reconstruct the huge chest wall defect,and covered by transferred muscle flaps.Results All the 33 patients underwent surgical reconstruction successfully and there was no perioperative death.Complete tumor resection was performed in all the patients,including 25 patients with malignant tumor and 8 patients with benign tumor.The diameter of the resected tumors ranged from 8 to 20 cm.All the patients were followed up from 5 to 60 months,except that 3 patients(9.09%) were lost during follow-up.There was no rejection response,abnormal breathing and foreign body sensation during follow-up.The infection incidence was 3%(1/33).Conclusion Gore-Tex patch is a safe and effective material for chest wall reconstruction due to its excellent biocompatibility.Appropriate selection of muscle flap for covering Gore-Tex patch can reduce postoperative complications.