urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.4.57KWGALNurmj-1572Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsРеконструкция грудной стенки при обширных резекциях. Обзор литературы. Собственный опытReconstruction of the Chest Wall During Extensive Resections. Literature Review. Own Experiencehttps://orcid.org/0000-0003-0355-807XРуденкоМ. С.RudenkoM. S.

Максим Сергеевич Руденко — заведующий отделением торакальной онкологии

Екатеринбург

Maxim S. Rudenko — Head of the Department of Thoracic Oncology

Ekaterinburg

r_ms@list.ruhttps://orcid.org/0000-0002-3063-3322КаменевР. О.KamenevR. O.

Роман Олегович Каменев — онколог отделения торакальной онкологии

Екатеринбург

Roman O. Kamenev — Oncologist of the Department of Thoracic Oncology

Ekaterinburg

fnikina@gmail.comhttps://orcid.org/0000-0002-1410-6653ГусевД. А.GusevD. A.

Дмитрий Андреевич Гусев — травматолог-ортопед онкологического отделения № 1

Екатеринбург

Dmitriy A. Gusev — Traumatologist-Orthopedist of the Oncology Department No. 1

Ekaterinburg

gusev-ortho@yandex.ruhttps://orcid.org/0000-0003-1441-4397ЕлисееваА. П.EliseevaA. P.

Анастасия Петровна Елисеева — онколог отделения торакальной онкологии

Екатеринбург

Anastasia P. Eliseeva — Oncologist of the Department of Thoracic Oncology

Ekaterinburg

appnat.ty@yandex.ruСвердловский областной онкологический диспансерРоссияSverdlovsk Regional Oncology CenterRussian Federation202403092024234Специальный выпуск «Онкология»57–76Copyright © Руденко М.С., Каменев Р.О., Гусев Д.А., Елисеева А.П., 20242024Руденко М.С., Каменев Р.О., Гусев Д.А., Елисеева А.П.Rudenko M.S., Kamenev R.O., Gusev D.A., Eliseeva A.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1572

Опухоли грудной стенки — редкое заболевание в клинической практике. Большинство опубликованных исследований опухолей грудной стенки обычно представляет собой одноцентровые ретроспективные исследования с участием небольшого числа клинических случаев. Таким образом, убедительная доказательная база, определяющая тактику хирургического лечения подобных пациентов в настоящее время отсутствует. В статье проведен обзор литературных данных, освещена эпидемиология опухолей грудной стенки. Подробно описаны виды материалов для реконструкции, используемые методы пластики грудной стенки при обширных резекциях, осложнения. Авторами представлен собственный опыт лечения 42 пациентов, которым по той или иной причине выполнялась резекция костных структур груди. По этиологии опухоли разделялись на немелкоклеточный рак легкого с инвазий в грудную стенку (9 случаев, 21,4 %), инвазию рака молочной железы (2 случая, 4,8 %), саркомы (хондросаркомы, остеосаркомы, саркомы мягких тканей — 13 случаев, 31 %), метастазы злокачественных опухолей различного происхождения и локализации (9 случаев, 21,4 %), доброкачественные образования (8 случаев, 19 %), десмоидная опухоль (1 случай, 2,4 %). 22 пациентам (52,3 %) выполнялась пластика образовавшегося дефекта, из них миопластика, пластика диафрагмой, местными тканями (8 случаев, 36,4 %), аллопластика полипропиленовой сеткой (6 случаев, 27,3 %), аллопластика полимерной пластиной (7 случаев, 16,7 %). В 3 случаях аллопластика дополнялась замещением мягких тканей торакодорзальным лоскутом. Описаны методы пластики и использованные материалы. В послеоперационном периоде авторы не наблюдали осложнений, связанных с парадоксальным дыханием.

Tumors of the chest wall are a relatively rare disease in clinical practice. Most published studies of chest wall tumors are typically single-center, retrospective studies involving small numbers of patients. Thus, evidence for clinical findings regarding chest wall tumors is currently lacking. The article reviews the literature and highlights the epidemiology of chest wall tumors. The types of materials for reconstruction, the methods used for chest wall plastic surgery for extensive resections, and complications are described in detail. The authors presented their own experience in treating 42 patients who, for one reason or another, underwent resection of the bone structures of the breast. According to the etiology, the tumors were divided into: non-small cell lung cancer with invasions into the chest wall (9 patients, 21.4 %), invasion of breast cancer (2 patients, 4.8 %), sarcomas (chondrosarcomas, osteosarcomas, soft tissue sarcomas; 13 patients, 31 %), metastases of malignant tumors of various origins and localization (9 patients, 21.4 %), benign tumors (8 patients, 19 %), dysmoid tumor (1 patient, 2.4 %). 22 (52.3 %) patients underwent plastic surgery of the resulting defect. Of these, myoplasty, plastic surgery with a diaphragm, local tissues (8 patients, 36.4 %), alloplasty with a polypropylene mesh (6 patients, 27.3 %), alloplasty with a polymer plate (7 patients, 16.7 %). In 3 cases, alloplasty was supplemented by replacement of soft tissues with a thoracodorsal flap. The methods of plastic surgery and the materials used are described. In the postoperative period, the authors did not observe complications associated with paradoxical breathing.

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The authors declare that there are no conflicts of interest present.