Application of Gore-Tex Patch in Chest Wall Reconstruction_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Chunguang , CHEN Hezhong , LI Zhigang

Department of Cardiothoracic Surgery, Shanghai Changhai Hospital, Second Military Medical University, Shanghai 200433, P. R. China;

Corresponding author：

Keywords：

Gore-Tex; Chest wall tumor; Muscle flap; Chest wall reconstruction

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Abstract： 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.

Citation： LI Chunguang,CHEN Hezhong,LI Zhigang,et al.. Application of Gore-Tex Patch in Chest Wall Reconstruction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 248-250. doi: Copy

1.	茅乃权，左传田，周元明，等. 胸壁肿瘤的外科治疗. 中国胸心血管外科临床杂志， 2005， 12 （4）：299-300．.
2.	Tan PW， Wong CH， Koong HN， et al. Chest wall reconstruction using a combined musculocutaneous anterolateral-anteromedial thigh flap. Indian J Plast Surg， 2010， 43 （1）：88-91.
3.	Daliakopoulos SI， Klimatsidas MN， Korfer R. Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap：a case report. J Med Case Reports，2010， 1 （4）：75.
4.	Schoenmaeckers EJ， van der Valk SB， van den Hout HW， et al. Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc， 2009， 23 （7）：1620-1623.
5.	Gonfiotti A， Santini PF， Campanacci D， et al. Malignant primary chest-wall tumours：techniques of reconstruction and survival. Eur J Cardiothorac Surg， 2010， 38 （1）：39-45.
6.	Incarbone M，Pastorino U. Surgical treatment of chest wall tumors. World J Surg， 2001， 25 （2）：218-230.
7.	Bosc R， Lepage C， Hamou C， et al. Management of chest wall reconstruction after resection for cancer： a retrospective study of 22 consecutive patients. Ann Plast Surg， 2011， 67 （3）， 263-268.
8.	Deschamps C， Tirnaksiz BM， Darbandi R， et al.Early and long-term results of prosthetic chest wall reconstruction.J Thorac Cardiovasc Surg，1999， 117（3）：588-591.
9.	李东，李健宁，牛星焘，等. 膨体聚四氟乙烯在整形外科的应用. 中华整形外科杂志， 200l， 17 （1）：43-45.
10.	Hamad AM， Marulli G， Bulf R， et al. Titanium plates support for chest wall reconstruction with Gore-Tex dual mesh after sternochondral resection. Eur J Cardiothorac Surg， 2009， 36 （4）：779-780.
11.	Danino A， Saito S， Mamlouk K， et al. Complete chest wall reconstruction after en bloc excisions with Gore-Tex/Marlex/Flap sandwich. A retrospective study of 14 cases. Ann Chir Plast Esthet， 2003， 48 （2）：86-92.
12.	Gapany C， Raffoul W， Zambelli PY， et al. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma. Pediatr Blood Cancer，2009， 52 （5）：679-681.
13.	D’Alessandro P， Carey-Smith R， Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma： a multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res， 2011， 97 （1）：73-78.
14.	Sunil I， Bond SJ， Nagaraj HS. Primitive neuroectodermal tumor of the sternum in a child： resection and reconstruction. J Pediatr Surg ，2006， 41 （11）：e5-e8.
15.	Hyans P， Moore JH Jr， Sinha L. Reconstruction of the chest wall with e-PTFE following major resection. Ann Plast Surg， 1992， 29 （4）：321-327.
16.	王昆，孙玉鹗. Gore-Tex修复大块胸壁缺损8例. 中华胸心血管外科杂志， 2001， 17（1）：49.
17.	Saiki M， Urata Y， Hamasaki T， et al. Mediastinal abdominal wall fistula due to ePTFE membrane. Kyobu Geka， 2008， 61 （2）：135-137.
18.	Nagayasu T， Yamasaki N， Tagawa T. Long-term results of chest wall reconstruction with DualMesh. Interact Cardiovasc Thorac Surg， 2010， 11 （5）：581-584.

1. 　茅乃权，左传田，周元明，等. 胸壁肿瘤的外科治疗. 中国胸心血管外科临床杂志， 2005， 12 （4）：299-300．.
2. 　Tan PW， Wong CH， Koong HN， et al. Chest wall reconstruction using a combined musculocutaneous anterolateral-anteromedial thigh flap. Indian J Plast Surg， 2010， 43 （1）：88-91.
3. 　Daliakopoulos SI， Klimatsidas MN， Korfer R. Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap：a case report. J Med Case Reports，2010， 1 （4）：75.
4. 　Schoenmaeckers EJ， van der Valk SB， van den Hout HW， et al. Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc， 2009， 23 （7）：1620-1623.
5. 　Gonfiotti A， Santini PF， Campanacci D， et al. Malignant primary chest-wall tumours：techniques of reconstruction and survival. Eur J Cardiothorac Surg， 2010， 38 （1）：39-45.
6. 　Incarbone M，Pastorino U. Surgical treatment of chest wall tumors. World J Surg， 2001， 25 （2）：218-230.
7. 　Bosc R， Lepage C， Hamou C， et al. Management of chest wall reconstruction after resection for cancer： a retrospective study of 22 consecutive patients. Ann Plast Surg， 2011， 67 （3）， 263-268.
8. 　Deschamps C， Tirnaksiz BM， Darbandi R， et al.Early and long-term results of prosthetic chest wall reconstruction.J Thorac Cardiovasc Surg，1999， 117（3）：588-591.
9. 　李东，李健宁，牛星焘，等. 膨体聚四氟乙烯在整形外科的应用. 中华整形外科杂志， 200l， 17 （1）：43-45.
10. 　Hamad AM， Marulli G， Bulf R， et al. Titanium plates support for chest wall reconstruction with Gore-Tex dual mesh after sternochondral resection. Eur J Cardiothorac Surg， 2009， 36 （4）：779-780.
11. 　Danino A， Saito S， Mamlouk K， et al. Complete chest wall reconstruction after en bloc excisions with Gore-Tex/Marlex/Flap sandwich. A retrospective study of 14 cases. Ann Chir Plast Esthet， 2003， 48 （2）：86-92.
12. 　Gapany C， Raffoul W， Zambelli PY， et al. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma. Pediatr Blood Cancer，2009， 52 （5）：679-681.
13. 　D’Alessandro P， Carey-Smith R， Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma： a multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res， 2011， 97 （1）：73-78.
14. 　Sunil I， Bond SJ， Nagaraj HS. Primitive neuroectodermal tumor of the sternum in a child： resection and reconstruction. J Pediatr Surg ，2006， 41 （11）：e5-e8.
15. 　Hyans P， Moore JH Jr， Sinha L. Reconstruction of the chest wall with e-PTFE following major resection. Ann Plast Surg， 1992， 29 （4）：321-327.
16. 　王昆，孙玉鹗. Gore-Tex修复大块胸壁缺损8例. 中华胸心血管外科杂志， 2001， 17（1）：49.
17. 　Saiki M， Urata Y， Hamasaki T， et al. Mediastinal abdominal wall fistula due to ePTFE membrane. Kyobu Geka， 2008， 61 （2）：135-137.
18. 　Nagayasu T， Yamasaki N， Tagawa T. Long-term results of chest wall reconstruction with DualMesh. Interact Cardiovasc Thorac Surg， 2010， 11 （5）：581-584.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Gore-Tex Patch in Chest Wall Reconstruction

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