Реконструкция грудной стенки при обширных резекциях. Обзор литературы. Собственный опыт
https://doi.org/10.52420/umj.23.4.57
EDN: KWGALN
Аннотация
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.
Ключевые слова
Об авторах
М. С. Руденко
Свердловский областной онкологический диспансер
Россия
Россия
Максим Сергеевич Руденко — заведующий отделением торакальной онкологии
Екатеринбург
Р. О. Каменев
Свердловский областной онкологический диспансер
Россия
Россия
Роман Олегович Каменев — онколог отделения торакальной онкологии
Екатеринбург
Д. А. Гусев
Свердловский областной онкологический диспансер
Россия
Россия
Дмитрий Андреевич Гусев — травматолог-ортопед онкологического отделения № 1
Екатеринбург
А. П. Елисеева
Свердловский областной онкологический диспансер
Россия
Россия
Анастасия Петровна Елисеева — онколог отделения торакальной онкологии
Екатеринбург
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Рецензия
Для цитирования:
Руденко МС, Каменев РО, Гусев ДА, Елисеева АП. Реконструкция грудной стенки при обширных резекциях. Обзор литературы. Собственный опыт. Уральский медицинский журнал. 2024;23(4):57–76. https://doi.org/10.52420/umj.23.4.57. EDN: KWGALN
For citation:
Rudenko MS, Kamenev RO, Gusev DA, Eliseeva AP. Reconstruction of the Chest Wall During Extensive Resections. Literature Review. Own Experience. Ural Medical Journal. 2024;23(4):57–76. (In Russ.) https://doi.org/10.52420/umj.23.4.57. EDN: KWGALN
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