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Front Surg 2022 9;9:845494. Epub 2022 Jun 9.

Department for Cardiothoracic Surgery, Medical Faculty, University Hospital Augsburg, Augsburg, Germany.

Introduction: Management of traumatic rib fractures is subject of controversial discussions. Rib fractures are common, especially after traffic accidents and falls. There is no consensus on whether and how many rib fractures need reconstruction. Read More

Adv Ther 2022 Jun 20. Epub 2022 Jun 20.

Division of Trauma, Department of Emergency, Kaohsiung-Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung, 813, Taiwan.

Introduction: Large-bore chest tubes are usually applied after thoracic surgery. Recently, small-bore tubes have been increasingly considered owing to the extensive use of video-assisted thoracoscopic surgery (VATS). This study assessed the differences in outcomes between large-bore and small-caliber drainage tubes in patients undergoing surgical stabilization of rib fractures (SSRF) with VATS. Read More

Case Rep Hematol 2022 9;2022:4700787. Epub 2022 Jun 9.

Department of Medicine, Section of Hematology-Oncology, Baylor College of Medicine, Houston 77030, TX, USA.

Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare disease entity associated with textured breast implants. Though the clinical course is typically indolent, BIA-ALCL can occasionally invade through the capsule into the breast parenchyma with spread to the regional lymph nodes and beyond including chest wall invasive disease.

Case: We present the case of a 51-year-old female with a history of bilateral silicone breast implants placed approximately twenty years ago who presented with two months of progressively enlarging right breast mass. Read More

Radiol Case Rep 2022 Aug 13;17(8):2894-2898. Epub 2022 Jun 13.

Department of Radiology, Yeungnam University College of Medicine, Daegu, Republic of Korea.

Osteoradionecrosis of the chest wall after radiation therapy for breast cancer is rare; however, it is one of the most severe complications of radiation treatment. Radiologically, osteoradionecrosis can manifest as a focal lucent area in bone, periostitis, sclerosis, and cortical irregularity of bones on X-ray or computed tomography; therefore, differentiation from bone metastasis can be challenging. Associated insufficiency fractures, ulceration, and skin necrosis may also occur. Read More

J Surg Case Rep 2022 Jun 16;2022(6):rjac276. Epub 2022 Jun 16.

Department of Breast Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK.

We describe the use of chest wall perforator flap (CWPF) to reconstruct the central mound of breast tissue in women presenting with central/retro areolar breast cancer. We describe the results of seven patients (median age, 59 years) with a median follow-up of 9 months. We were able to conserve the breast in all except one woman who was found to have extensive DCIS. Read More

Breast J 2022 29;2022:5482261. Epub 2022 Mar 29.

Department of Plastic & Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.

Introduction: Less than 1% of all breast cancers are diagnosed in males. In females, postmastectomy breast reconstruction is associated with increased patient satisfaction. However, there is a paucity of literature describing reconstructive options for postmastectomy deformity in the male chest. Read More

JTCVS Tech 2022 Jun 22;13:250-260. Epub 2022 Feb 22.

Section of Thoracic Surgery, Department of Cardio-Thoracic and Vascular Surgery, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.

Objectives: The aim of the study is to evaluate clinical applications, safety, and effectiveness of a porcine-derived acellular cross-linked dermal matrix biological mesh in chest wall reconstruction.

Methods: We retrospectively analyzed a prospective multicenter database of chest wall reconstructions using a biological mesh in adult patients undergoing operation between October 2013 and December 2020. We evaluated preoperative data, type of resection and reconstruction, hospitalization, 30-day morbidity and mortality, and overall survival. Read More

JTCVS Tech 2022 Jun 19;13:261-262. Epub 2022 Feb 19.

Division of Thoracic and Esophageal Surgery, Department of Thoracic and Cardiovascular Surgery, Allegheny General Hospital, Pittsburgh, Pa.

Transl Cancer Res 2022 May;11(5):1162-1172

Department of Thoracic Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.

Background: Chest wall resections/reconstructions are a validated approach to manage tumors invading the thorax. However, how resection characteristics affect postoperative morbidity and mortality is unknown. We determined the impact of chest wall resection size and location on patient short and long-term postoperative outcomes. Read More

Cureus 2022 May 11;14(5):e24924. Epub 2022 May 11.

Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA.

Pneumothorax is a known complication following breast surgery but is likely underappreciated by anesthesiologists. Iatrogenic pneumothorax can be caused by needle injury during local anesthetic injection, surgical damage to the intercostal fascia or pleura, or pulmonary injury from mechanical ventilation. We present two cases of pneumothorax following bilateral mastectomy with bilateral pectoral blocks and immediate breast reconstruction. Read More

Case Rep Oncol 2022 Jan-Apr;15(1):403-412. Epub 2022 Apr 21.

National Institute of Cancer, Universidad del Bosque, Bogotá, Colombia.

Primary sarcomas of the breast are heterogeneous neoplasms derived from the non-epithelial elements of the mammary gland. Malignant peripheral nerve sheath tumors comprise 5-10% of all malignant soft tissue sarcomas. Its heterogeneity and low incidence (1 in 100,000) limit the performance of prospective studies. Read More

Plast Reconstr Surg Glob Open 2022 May 13;10(5):e4326. Epub 2022 May 13.

Division of Plastic, Reconstructive & Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.

Reconstruction of large chest wall defects is challenging. Here we discuss the process of decision-making in planning chest wall reconstruction, considering the requirements of tumor removal, stabilization of the chest wall, and soft tissue coverage, illustrated by a case of a hemi-chest wall defect in a child. Ewing sarcoma measuring 10 × 9 × 13 cm was resected in a 9-year-old boy, followed by stabilization using a Gore-Tex patch. Read More

Innovations (Phila) 2022 May-Jun;17(3):191-200

Department of Cardiothoracic Surgery, 97701Morriston Hospital, Swansea Bay University Health Board, Wales, UK.

Large chest wall defects, as a result of wide local excision of chest wall pathology, require skeletal and soft-tissue reconstruction to restore the anatomical shape, structure, and respiratory function of the thorax. Reconstruction is challenging and requires the surgical reconstructive team to understand the anatomic and physiologic morbidity related to the defect and the choice of reconstructive techniques available to restore form and function. Rapidly emerging 3-dimensional (3D) printing technology allows the reconstructive surgical team to customize the therapeutic process of skeletal reconstruction by accurately mimicking the shape and structure of the chest wall being replaced. Read More

Clin Breast Cancer 2022 May 6. Epub 2022 May 6.

Cambridge University Hospitals, Breast Unit, Cambridge Biomedical Research Centre, Cambridge, United Kingdom. Electronic address:

Background: Increasingly, breast surgery is same day or 23-hour day-case surgery. Discharge criteria need to ensure patient safety outside hospital. We explore some of the evolving day-case factors in oncoplastic breast surgery (OBS). Read More

Eur J Surg Oncol 2022 May 25. Epub 2022 May 25.

Oncoplastic Breast Surgeon at "L'Institut Du Sein-The Paris Breast Centre", Paris, France.

Background: Lateral dog ear after mastectomy in overweight or large breasted patients is a source for patient discomfort and is aesthetically unpleasing. Although many different techniques have been proposed, none of them have emerged as standard. In 2012, the authors published their mastectomy technique based on an inverted L-scar incision and closure with a lateral skin flap advanced supero-medially onto the chest wall. Read More

Front Pediatr 2022 17;10:846630. Epub 2022 May 17.

Department of Pediatric Surgery, University Children's Hospital Mannheim, University of Heidelberg, Mannheim, Germany.

Objective: In patients with a congenital diaphragmatic hernia (CDH), postoperative small bowel obstruction (SBO) is a life-threatening event. Literature reports an incidence of SBO of 20% and an association with patch repair and ECMO treatment. Adhesions develop due to peritoneal damage and underly various biochemical and cellular processes. Read More

J Plast Reconstr Aesthet Surg 2022 Apr 30. Epub 2022 Apr 30.

Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 33 Ba-Da-Chu Road, Beijing, 100144, China. Electronic address:

The pedicled lower trapezius musculocutaneous flap (LTMF) can extend far beyond the lateral border of the trapezius muscle, with a reliable blood supply. However, the distal part of the extended LTMF lacks a muscular component, limiting its usage in complex defect reconstruction, which often requires obliteration of dead space and coverage of vital structures. To overcome this limitation, we modified the LTMF by adding a segment of latissimus dorsi muscle (LDM). Read More

Trauma Case Rep 2022 Aug 24;40:100659. Epub 2022 May 24.

Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, 1-3-1 Wakinohamakaigandori, Chuo-ku, Kobe, Hyogo 651-0073, Japan.

Background: Although the Hybrid Emergency Room System (HERS) is a relatively novel method for treating severe trauma patients, there have been few reported cases of gunshot wound patients treated in HERS. Here we report our treatment of a unique gunshot wound case, with shock, in a HERS setting.

Case Presentation: A 72-year-old male was transferred to our hospital due to a gunshot wound (GSW). Read More

Int J Surg Case Rep 2022 Jun 20;95:107229. Epub 2022 May 20.

Dept of General Surgery, Apollo Hospitals Int Ltd, Gandhinagar, Gujarat, India.

Introduction And Importance: Necrotizing soft tissue infections (NSTI) are caused by toxin-producing bacteria and fungi that results in rapid progression of disease with significant local tissue destruction.

Case Presentation: We present a case report of a 57-year-old male patient in line with the SCARE 2020 criteria. He was admitted to the emergency department with a small abrasion on the right antero-lateral chest wall, and a diffuse necrotic patch of skin and soft tissues with purulent discharge. Read More

J Surg Case Rep 2022 May 23;2022(5):rjac135. Epub 2022 May 23.

Division of General Surgery, Kingston Public Hospital, Kingston, Jamaica.

The pedicled transverse rectus abdominis myocutaneous (TRAM) flap is an infrequently performed procedure relative to the more current microsurgical free tissue transfers in most centres around the world. However, in resource-limited centres where procedures requiring microsurgical intervention are rarely employed, the pedicled TRAM whose vascular axis is that of the superior epigastric artery, is an invaluable tool in the plastic surgeon's armamentarium both for breast reconstruction and chest wall soft tissue resurfacing. This a report of a case of variable anatomical vascular perforating branch of the internal thoracic artery, which was encountered while using a TRAM to resurface a chest wall defect after mastectomy was performed for locally advanced breast cancer. Read More

Proc SPIE Int Soc Opt Eng 2022 Feb-Mar;12034. Epub 2022 Apr 4.

Vanderbilt University, Department of Biomedical Engineering, Nashville, TN USA.

Breast cancer is the most common cancer in women, and surgical resection is standard of care for the majority of breast cancer patients. Unfortunately, current reoperation rates are 10-29%. Uncertainty in lesion localization is one of the main factors contributing to these high reoperation rates. Read More

Case Rep Gastroenterol 2022 Jan-Apr;16(1):252-257. Epub 2022 Apr 7.

University of Kansas Medical Center, Kansas City, Kansas, USA.

The diagnosis of gastric volvulus can be a clinical challenge as it is rare, and the symptoms are often nonspecific and intermittent. Upper endoscopy is a minimally invasive intervention that may be repeated more than once to provide key information and ultimately establish such a diagnosis. To emphasize the role of upper endoscopy in surgical cases with recurrent upper gastrointestinal obstructions, we present a case of intermittent gastric volvulus in a patient with a remote history of complex chest wall reconstruction for invasive breast cancer using an omental flap. Read More

J Vis Exp 2022 05 4(183). Epub 2022 May 4.

Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill;

The increased use of chest computed tomography (CT) has led to an increased detection of pulmonary nodules requiring diagnostic evaluation and/or excision. Many of these nodules are identified and excised via minimally invasive thoracic surgery; however, subcentimeter and subsolid nodules are frequently difficult to identify intra-operatively. This can be mitigated by the use of electromagnetic transthoracic needle localization. Read More

Ann Surg Oncol 2022 May 21. Epub 2022 May 21.

Department of Surgical Oncology, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon peripheral T cell lymphoma arising in response to textured-surface breast implants. Frequently, BIA-ALCL is indolent and typically presents with peri-implant swelling after breast reconstruction or cosmetic augmentation. However, patients can present with an invasive breast or chest wall mass, palpable lymphadenopathy, or metastatic disease. Read More

Clin Transl Radiat Oncol 2022 Jul 4;35:37-43. Epub 2022 May 4.

Radiation Oncology, Institut Claudius Regaud, IUCT-O, Toulouse, France.

Introduction: We report on our experience of using Helical Tomotherapy (HT) in the context of post-mastectomy radiation therapy (PMRT) with or without immediate implant-based breast Reconstruction (IBR).

Material And Methods: The study included a total of 173 patients who underwent PMRT with HT between 2013 and 2015 in our institution (87 immediate breast reconstructions with retropectoral implants (IBR + ), 86 without reconstructions (IBR-)). The chest wall target volume included subcutaneous tissue and pectoralis muscle and excluded the posterior region of the implant as well as the ribs. Read More

World J Clin Cases 2022 Apr;10(11):3505-3510

Department of Vascular, Thyroid, and Breast Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China.

Background: Chronic radiative chest wall ulcers are common in patients undergoing radiation therapy. If not treated early, then symptoms such as erosion, bleeding and infection will appear on the skin. In severe cases, ulcers invade the ribs and pleura, presenting a mortality risk. Read More

J Cardiothorac Surg 2022 May 12;17(1):116. Epub 2022 May 12.

Department of Bone and Soft Tissue, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

Objective: To evaluate the experience and effects of resection and reconstruction of 4 cases of huge tumors in the chest wall.

Methods: The clinical data of 4 patients with huge tumors in the chest wall from July 2015 to January 2020 were collected and analyzed. There were 2 males and 2 females. Read More

Acta Chir Belg 2022 May 22:1-7. Epub 2022 May 22.

Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Ghent, Belgium.

Introduction: To report a case of radiation necrosis after reirradiation for breast cancer and the difficulties encountered when treating these complex cases.

Patients And Methods: We present an 86-year-old woman with a history of right-sided intraductal breast cancer treated with a right mastectomy followed by local adjuvant radiotherapy (50 Gray). Twelve years later, she was diagnosed with a local recurrence in the mastectomy scar which was treated with local resection (including resection of rib four) and adjuvant radiotherapy up to 32 Gray. Read More

J Med Case Rep 2022 May 10;16(1):186. Epub 2022 May 10.

Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, 130 East 77th Street, 4th floor, New York, NY, 10075, USA.

Background: Fungal prosthetic graft infections are associated with high mortality, typically requiring aggressive surgical debridement. We present an alternative, minimally invasive approach to address these challenging clinical cases.

Case Presentation: A 76-year-old Caucasian male with prior aortic root and arch replacement presented with localized chest wall tenderness after being hit by a car door. Read More

Case Rep Oncol 2022 Jan-Apr;15(1):351-355. Epub 2022 Mar 30.

Department of Breast Surgery, Kobe University Hospital, Kobe, Japan.

A 56-year-old female patient with left breast cancer presented at our hospital. Preoperative CT scan showed an isolated bilateral pectoralis major muscle defect and abnormal muscle originating from the entire sternum and inserting in the lower ribs and rectus sheath. Total mastectomy and axillary lymph node dissection were performed. Read More