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The Nipple Split Sharing vs. Conventional Nipple Graft Technique in Chest Wall Masculinization Surgery: Can We Improve Patient Satisfaction and Aesthetic Outcomes?

Aesthetic Plast Surg 2020 Jun 4. Epub 2020 Jun 4.

Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, USA.

Background: Double incision mastectomy with free nipple grafts (DIFNG) offers more flexible nipple-areola complex (NAC) resizing and repositioning in transmale and gender non-conforming individuals. The cis-male NAC has a smaller diameter, oval shape and lateral position. If nipple grafts are performed without having these considerations, aesthetics can be dissatisfying. Read More

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http://dx.doi.org/10.1007/s00266-020-01803-1DOI Listing

Autologous costochondral graft harvest in children.

Int J Pediatr Otorhinolaryngol 2020 May 16;135:110111. Epub 2020 May 16.

Divisions of Pediatric Otolaryngology and Facial Plastic Surgery, Department of Otolaryngology, Tufts Medical Center, Boston, MA, United States; Floating Hospital for Children at Tufts Medical Center, Boston, MA, United States. Electronic address:

Introduction: Autologous costochondral grafting is a commonly employed technique in pediatric otolaryngology for reconstructing a cartilaginous or bony structure, such as the trachea, larynx, nose or mandible by harvesting rib cartilage or bone from the same patient. Complications include infection, pneumothorax, hematoma, scarring, and pleural leak, and the literature regarding these complication rates in pediatric patients undergoing this procedure is sparse. The objective of this study was to determine the donor site complication rate associated with rib graft harvest procedures performed by pediatric otolaryngologists in infants and children and to compare this to established complication rates reported in adults. Read More

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http://dx.doi.org/10.1016/j.ijporl.2020.110111DOI Listing

Multifocal intra-parenchymal and sub-pectoral malignant phyllodes tumor in young female, rare and unusual presentation: A case report.

Int J Surg Case Rep 2020 May 22;71:280-284. Epub 2020 May 22.

General Surgery Resident, Jordan Ministry of Health, Jordan.

Introduction: Phyllodes tumors are rare fibroepithelial breast tumors, accounting for less than 1% of all breast tumors. Most Phyllodes tumors are benign. However, about 10% are malignant. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.05.014DOI Listing

Delayed post-traumatic presentation of severe sternal osteomyelitis: A strong multidisciplinary effort and a novel reconstruction technique for a challenging case.

Trauma Case Rep 2020 Jun 17;27:100305. Epub 2020 May 17.

Thoracic Surgery Unit, Southampton University Hospital, UK.

Sternal osteomyelitis is a morbid and challenging condition, which can rarely occur after trauma, with no established consensus over best therapeutic options. In this case, a 47-year-old man with history of intravenous drug use presented 11 weeks after a minor blunt chest trauma with a severe necrotizing osteomyelitis involving sternum, muscles, fascia and subcutaneous tissue and positive blood cultures for Methicillin Sensitive . Alongside tailored antibiotic therapy, extensive surgical debridement was performed, leaving a full thickness 3 × 4 cm sternal defect and a large skin defect. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236049PMC

Less Invasive Management of Tissue Deficits for Deep Sternal Wound Infections.

Plast Reconstr Surg Glob Open 2020 Apr 30;8(4):e2776. Epub 2020 Apr 30.

Department of Plastic and Reconstructive Surgery, Saga University School of Medicine, Saga, Japan.

Background: The frequency of sternomyelitis after cardiovascular surgery has been reported to be 0.4% -5%.

Methods: The treatment method used for 47 patients (29 male and 18 female) who developed sternomyelitis after sternotomy with tissue defects in the chest was examined retrospectively. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209903PMC

Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap.

Sci Rep 2020 May 20;10(1):8380. Epub 2020 May 20.

Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Background: The pectoralis major flap, which is usually harvested bilaterally, is considered a workhorse flap in the reconstruction of sternal defects. After a median sternotomy for open heart surgery, 1%-3% of patients develop deep infection and dehiscence of the sternal wound, some of which will eventually require reconstructive surgery. Our aim was to describe the clinical feasibility and associated complications of the unilateral pectoralis major advancement flap in the reconstruction of sternal defects. Read More

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http://dx.doi.org/10.1038/s41598-020-65398-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239941PMC

Use of custom made 3-dimensional printed surgical guide for manubrio-sternal resection of solitary breast cancer metastasis: case report.

AME Case Rep 2020 30;4:12. Epub 2020 Apr 30.

Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.

A 44-year-old lady with solitary 4.4-cm metastasis to the manubrium from a previously resected invasive ductal carcinoma of the left breast underwent manubrio-sternal resection. We describe our unique approach of using 3-dimensional (3D)-computed tomography (CT) image segmentation planning for reconstructing desirable resection boundaries, design of ideal superficial and deep surgical resection guides, and followed by 3D printing of guides using autoclavable thermoplastic for use during surgery. Read More

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http://dx.doi.org/10.21037/acr.2020.03.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221324PMC

Successful surgical treatment of Cronkhite-Canada Syndrome with bilateral flail chest: a case report.

BMC Surg 2020 May 13;20(1):103. Epub 2020 May 13.

Department of Thoracic Surgery, First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, People's Republic of China.

Background: Development of multiple rib fractures leading to bilateral flail chest in Cronkhite-Canada Syndrome (CCS) has not been reported.

Case Presentation: A 59-year-old man presented with complaints of fatigue, chest pain, respiratory distress and orthopnea requiring ventilatory support to maintain oxygenation. CCS with bilateral anterior and posterior flail chest due to multiple rib fractures (2nd-10th on the right side and 2nd-11th on the left side). Read More

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http://dx.doi.org/10.1186/s12893-020-00766-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222535PMC

Neoadjuvant Radio(chemo)therapy for Breast Cancer: An Old Concept Revisited.

Breast Care (Basel) 2020 Apr 14;15(2):112-117. Epub 2020 Apr 14.

Department of Radiation Oncology, Heinrich Heine University Hospital, Düsseldorf, Germany.

Background: The international standard of care for the treatment of high-risk breast cancer (BC) consists of neoadjuvant chemotherapy (NACT) and surgery followed by adjuvant whole breast/chest wall irradiation. In this setting, the time interval from the start of NACT to the end of radiotherapy (RT) is usually postponed to 6 months or longer. In addition to this, a high percentage of capsular fibrosis may occur when breast implants are irradiated. Read More

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http://dx.doi.org/10.1159/000507041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204855PMC

[Resection of Anterior Mediastinal Tumor Followed by Left Brachiocephalic Vein Reconstruction;Report of a Case].

Kyobu Geka 2020 May;73(5):384-387

Department of Cardiovascular Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan.

A 65-year-old man was referred to our hospital because of an abnormal shadow on a chest radiogram. Swelling of the face and upper limbs were noted. Enhanced computed tomography showed a 62×101 mm mass in the anterior mediastinum with invasion to the superior vena cava (SVC) and the right upper lobe of the lung. Read More

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Multidisciplinary approach to chest wall reconstruction in primary breast angiosarcoma resection.

BMJ Case Rep 2020 May 6;13(5). Epub 2020 May 6.

Department of Surgery, Galway University Hospitals, Galway, Ireland.

Angiosarcomas account for less than 1% of primary breast cancers. Typically, they occur in young women with a low-risk personal or family history. Diagnosis, resection and reconstruction require a multidisciplinary team of breast surgeons, oncologists and plastic reconstructive surgeons. Read More

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http://dx.doi.org/10.1136/bcr-2019-233156DOI Listing

Nipple-sparing mastectomy for breast cancer close to the nipple: a single institution's 11-year experience.

Breast Cancer 2020 May 5. Epub 2020 May 5.

Department of Surgery and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

Background: This study aimed to analyze our 11-year experience using NSM with immediate breast reconstruction in breast cancer.

Methods: Between January 2007 and December 2015, 251 NSMs were performed on 251 women with breast cancer for therapeutic purpose at Pusan National University Hospital.

Results: The clinical and pathologic mean tumor size was 3. Read More

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http://dx.doi.org/10.1007/s12282-020-01104-0DOI Listing

Epithelioid hemangioendothelioma of the sternum.

Thorac Cancer 2020 Jun 28;11(6):1741-1745. Epub 2020 Apr 28.

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor composed of dendritic and endothelial cells, and accounts for less than 1% of all vascular tumors. The tumor may arise from any location in the body, but it has a predilection for veins of the extremities, the liver, bone, and skin. Herein, we report a case of a 43-year-old man who presented with a chest mass accompanied by chest pain. Read More

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http://dx.doi.org/10.1111/1759-7714.13454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262933PMC

Dedicated cone-beam breast CT using laterally-shifted detector geometry: Quantitative analysis of feasibility for clinical translation.

J Xray Sci Technol 2020 Apr 22. Epub 2020 Apr 22.

Department of Medical Imaging, University of Arizona, Tucson, AZ, USA.

Background: High-resolution, low-noise detectors with minimal dead-space at chest-wall could improve posterior coverage and microcalcification visibility in the dedicated cone-beam breast CT (CBBCT). However, the smaller field-of-view necessitates laterally-shifted detector geometry to enable optimizing the air-gap for x-ray scatter rejection.

Objective: To evaluate laterally-shifted detector geometry for CBBCT with clinical projection datasets that provide for anatomical structures and lesions. Read More

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http://dx.doi.org/10.3233/XST-200651DOI Listing

Soft-Tissue Reconstruction after Composite Vertebrectomy and Chest Wall Resection for Spinal Tumors.

Plast Reconstr Surg 2020 May;145(5):1275-1286

Houston, Texas; and Pittsburgh, Pa. From the Departments of Plastic Surgery, Neurosurgery, and Thoracic Surgery, University of Texas M. D. Anderson Cancer Center; and the Department of Surgery, Division of Plastic Surgery, Allegheny General Hospital.

Background: Oncologic resections involving both the spine and chest wall commonly require immediate soft-tissue reconstruction. The authors hypothesized that reconstructions of composite resections involving both the thoracic spine and chest wall would have a higher complication rate than reconstructions for resections limited to the thoracic spine alone.

Methods: The authors performed a retrospective analysis of all consecutive patients who underwent a thoracic vertebrectomy and soft-tissue reconstruction from 2002 to 2017. Read More

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http://dx.doi.org/10.1097/PRS.0000000000006792DOI Listing

Osteoradionecrosis of the Chest Wall.

Plast Reconstr Surg Glob Open 2020 Feb 25;8(2):e2665. Epub 2020 Feb 25.

Department of Pathology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.

We present the case of a 48-year-old woman with a chronic ulcer with bony erosion over the right chest wall who had undergone adjuvant chemoradiotherapy for right breast cancer 18 years previously. Preoperative computed tomography revealed a large soft tissue ulcerative lesion with bony destruction of the anterolateral aspect of the right fifth and sixth ribs. Biopsy showed no evidence of recurrent malignancy. Read More

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http://dx.doi.org/10.1097/GOX.0000000000002665DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159944PMC
February 2020

Utility of CT Angiography for the Prediction of Coronary Artery Compression in Patients Undergoing Transcatheter Pulmonary Valve Replacement.

World J Pediatr Congenit Heart Surg 2020 May;11(3):295-303

David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Objectives: We aimed to evaluate the utility of computed tomography angiography (CTA) for coronary compression (CC) prediction in patients with congenital heart disease undergoing balloon-expandable transcatheter pulmonary valve replacement (TPVR).

Background: Coronary compression is a serious complication of TPVR, but the value of preprocedural CTAs to assess CC risk is largely unexplored.

Methods: In all, 586 patients underwent TPVR between January 2009 and July 2018. Read More

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http://dx.doi.org/10.1177/2150135120905670DOI Listing

The surgical management of sarcomas of the chest wall: A 13-year single institution experience.

J Plast Reconstr Aesthet Surg 2020 Mar 4. Epub 2020 Mar 4.

The North of England Bone and Soft Tissue Tumour Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.

Introduction: Chest wall sarcomas are rare. Resection and reconstruction pose significant anatomical and functional challenges. We present our experience of managing these tumours as plastic surgeons working within a specialist sarcoma MDT. Read More

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http://dx.doi.org/10.1016/j.bjps.2020.02.036DOI Listing

5-Year Update of a Multi-Institution, Prospective Phase 2 Hypofractionated Postmastectomy Radiation Therapy Trial.

Int J Radiat Oncol Biol Phys 2020 Apr 11. Epub 2020 Apr 11.

Memorial Sloan Kettering Cancer Center, New York City, New York.

Purpose: Hypofractionation in the setting of postmastectomy radiation (PMRT) is not currently the standard of care in most countries. Here we present a 5-year update of our multi-institutional, phase 2 prospective trial evaluating a novel 15-day hypofractionated PMRT regimen.

Methods And Materials: Patients were enrolled to receive 3. Read More

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http://dx.doi.org/10.1016/j.ijrobp.2020.03.020DOI Listing

Definition of Tumor Bed Boost in Oncoplastic Breast Surgery: An Understanding and Approach.

Clin Breast Cancer 2020 Mar 20. Epub 2020 Mar 20.

Breast Surgery, Cambridge University Hospitals, Cambridge, UK. Electronic address:

Introduction: Definition of the tumor bed (TB) is currently guided by intraoperatively placed metal clips. However, this traditional planning method may not be sufficient for tumor cavity defect refilled with modern oncoplastic breast surgery. We explored the impact of a close cooperation between surgeon and oncologist on the accuracy of TB contouring after partial breast reconstruction with chest wall perforator flaps (CWPF). Read More

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http://dx.doi.org/10.1016/j.clbc.2020.03.003DOI Listing

The Morphology and Bending Behavior of Regenerated Costal Cartilage with Kawanabe-Nagata Method in Rabbits - the Short Term Result of an Experimental Study.

J Invest Surg 2020 Apr 13:1-5. Epub 2020 Apr 13.

Ear reconstruction center, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Bejing, People's Republic of China.

The chest wall deformity is a well-known complication following costal cartilage harvest with the biomechanical factor considered to be a cause of this donor-site morbidity. Kawanabe-Nagata method is a widely-accepted approach to prevent the deformity. However, knowledge about the biomechanical properties of regenerated costal cartilage is limited, and the value of reimplantation of autologous costal cartilage blocks is not clear. Read More

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http://dx.doi.org/10.1080/08941939.2020.1741744DOI Listing

Three-Dimensional-Printed Model as a Template for Chest Wall Reconstruction.

Heart Lung Circ 2020 Apr 2. Epub 2020 Apr 2.

Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA.

Background: To our knowledge, this is the first time that a three-dimensional (3D)-printed model was used as an intraoperative template to recreate the resected portion of the lateral chest wall after resection of a large chest-wall tumour.

Methods: Fabrication of 3D-printed models requires collaboration among a surgeon, radiologist, segmenter, and 3D printing centre. Three-dimensional models are created with computed tomographic and magnetic resonance data. Read More

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http://dx.doi.org/10.1016/j.hlc.2020.02.004DOI Listing
April 2020
1.172 Impact Factor

Reconstruction of massive chest wall defects: A 20-year experience.

J Plast Reconstr Aesthet Surg 2020 Feb 17. Epub 2020 Feb 17.

Department of Plastic Surgery, MD Anderson Cancer Center, University of Texas, Houston, Texas, USA. Electronic address:

Background: Large chest wall resections can result in paradoxical chest wall movement leading to prolonged ventilator dependence and major respiratory impairment. The purpose of this study was to determine as to which factors are predictive or protective of complications in massive oncologic chest wall defect reconstructions.

Methods: A retrospective review of a prospectively maintained database of consecutive patients who underwent immediate reconstruction of massive thoracic oncologic defects (≥5 ribs) was performed. Read More

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http://dx.doi.org/10.1016/j.bjps.2020.02.010DOI Listing
February 2020
1.474 Impact Factor

Consistent and invertible deformation vector fields for a breathing anthropomorphic phantom: a post-processing framework for the XCAT phantom.

Phys Med Biol 2020 Apr 1. Epub 2020 Apr 1.

Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering London, University College London, London, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.

Breathing motion is challenging for radiotherapy planning and delivery. This requires advanced four-dimensional (4D)-imaging and motion mitigation strategies and associated validation tools with known deformations. Numerical phantoms such as the XCAT provide reproducible and realistic data for simulation-based validation. Read More

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http://dx.doi.org/10.1088/1361-6560/ab8533DOI Listing

Masquelet Technique for Chest Wall Reconstruction: A Case Report.

JBJS Case Connect 2020 Jan-Mar;10(1):e0011

Department of Orthopaedic Surgery, OhioHealth Doctors Hospital, Columbus, Ohio.

Case: A 33-year-old man with recurrent intrathoracic scapular dislocation due to previous trauma-related chest wall resection successfully underwent the 2-stage induced membrane technique commonly known as the Masquelet technique; this procedure effectively created 2 new ribs that resolved his symptoms.

Conclusions: Techniques for chest wall reconstruction for bone loss are quite limited, and these often consist of filling defects with a layered patch; this often cannot withstand the cyclical respiratory motion. Use of the induced membrane technique appears to carry potential when used in the chest wall, and this report describes a technique by which this procedure can be reliably performed. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00011DOI Listing

Schwannoma of the intercostal nerve presenting as chest pain.

Ann Thorac Surg 2020 Mar 26. Epub 2020 Mar 26.

Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address:

A wide variety of benign and malignant tumors develop in the chest wall and pose a diagnostic and therapeutic challenge to clinicians. Chest wall schwannomas of the intercostal nerve are rare. We describe the clinical and imaging findings of a patient who presented with persistent and progressive chest pain. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.02.044DOI Listing

Chest wall perforator flaps for partial breast reconstruction: Surgical outcomes from a multicenter study.

Arch Plast Surg 2020 Mar 15;47(2):153-159. Epub 2020 Mar 15.

Department of Breast and General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

Background: Perforator artery flaps based on the branches of intercostal arteries and lateral thoracic artery can be used for reconstruction after breast-conserving surgery (BCS). Although described more than a decade ago, these have not been adopted widely in clinical practice. We report on short-term and long-term surgical outcomes of partial breast reconstruction using chest wall perforator flaps from a prospective multicenter audit. Read More

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http://dx.doi.org/10.5999/aps.2019.01186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7093273PMC

The Modified Extended Fleur-De-Lis Latissimus Dorsi Flap for Various Complex Multi-directional Large Soft and Bone Tissue Reconstruction.

Cureus 2020 Feb 12;12(2):e6974. Epub 2020 Feb 12.

Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, TWN.

Introduction Latissimus Dorsi (LD) myocutaneous flap is a workhorse flap for various large reconstructions. Variants described to increase its volume are referred to as extended LD flaps. The extended fleur-de-lis LD is one of these variants. Read More

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http://dx.doi.org/10.7759/cureus.6974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7075478PMC
February 2020

Post-mastectomy immediate breast reconstruction and adjuvant radiotherapy: long term results of a mono institutional experience.

Radiol Med 2020 Mar 12. Epub 2020 Mar 12.

Radiation Oncology Department, Sant'Andrea Hospital, La Sapienza II University of Rome, Via di Grottarossa 1035, Rome, Italy.

Introduction: The aim of this paper is to investigate the outcome of patients treated with mastectomy, immediate breast reconstruction (IBR) and post-mastectomy radiotherapy (PMRT) and the risk of late complications.

Material And Method: All patients had post-mastectomy, immediate reconstructive surgical procedure by using autologous abdominal implant; tissue expander (TE)/permanent prosthesis (PP); or even combined procedures. Adjuvant external beam radiotherapy treatment (EBRT) was delivered to the reconstructed chest wall and supraclavicular nodes, for a total dose of 50 Gy in 25 fractions. Read More

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http://dx.doi.org/10.1007/s11547-020-01161-7DOI Listing

Primary paediatric chest wall tumours necessitating surgical management.

Ann R Coll Surg Engl 2020 May 11;102(5):335-339. Epub 2020 Mar 11.

Oxford University Hospitals NHS Foundation Trust, UK.

Introduction: Limited literature exists on oncological chest wall reconstruction in the paediatric population, with the field still largely undecided on the best surgical reconstructive techniques to employ. The use of biological grafts/meshes is gaining popularity in certain adult surgical procedures but their use in paediatric procedures is rarely reported in the literature. We present the outcomes of our institution's multidisciplinary approach to managing paediatric chest wall tumours as well as our experience with the use of biological grafts for chest wall reconstruction following oncological resections. Read More

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http://dx.doi.org/10.1308/rcsann.2020.0025DOI Listing

[A Case Report on Larynx-Preserving Surgery with Tracheal Resection of an Advanced Esophageal Cancer with Tracheal Invasion].

Gan To Kagaku Ryoho 2019 Dec;46(13):2530-2532

Dept. of Gastroenterological Surgery, Graduate School of Medicine, Osaka University.

We present the case of a 69-year-old man who was diagnosed with ascending colon cancer. Preoperative CT revealed 2 advanced esophageal cancers, both at T4; thus, a diagnosis of esophageal cancer(Ut-Ce, cT4b[Tr]N2M0, Stage ⅣA/Mt, cT4b[Lt-Br]N2M0, Stage ⅣA)was made. The patient received chemotherapy(DTX/CDDP/5-FU), and as the second-line treatment, he received chemoradiotherapy(40 Gy with DTX/CDDP/5-FU). Read More

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December 2019

Synthetic Mesh Versus Acellular Dermal Matrix for Oncologic Chest Wall Reconstruction: A Comparative Analysis.

Ann Surg Oncol 2020 Mar 9. Epub 2020 Mar 9.

Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Management of chest wall defects after oncologic resection is challenging due to multifactorial etiologies. Traditionally, skeletal stabilization in chest wall reconstruction (CWR) was performed with synthetic prosthetic mesh. The authors hypothesized that CWR for oncologic resection defects with acellular dermal matrix (ADM) is associated with a lower incidence of complications than synthetic mesh. Read More

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http://dx.doi.org/10.1245/s10434-019-08168-zDOI Listing

Forequarter Amputation and Reconstructive Options.

Ann Plast Surg 2020 Jun;84(6):651-656

Department of Plastic Surgery, Oulu University Hospital, Oulu, Finland.

Objective: This study aimed to present the results of a series of forequarter amputations (FQAs) and to evaluate the reconstructive methods used.

Summary Background Data: Although FQA has become a rare procedure in the era of limb-sparing treatment of extremity malignancies, it is a useful option when resection of a shoulder girdle or proximal upper extremity tumor cannot be performed so as to retain a functional limb.

Methods: Thirty-four patients were treated with FQA in 1989 to 2017. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002204DOI Listing

Case Report of a Complex Chest Wall Reconstruction with a Cadaveric Achilles Tendon.

Am J Case Rep 2020 Mar 6;21:e920910. Epub 2020 Mar 6.

Department of Cardiovascular Surgery, Sentara Health System, Norfolk, PA, USA.

BACKGROUND Chest wall reconstruction is sometimes needed after resection of a thoracic malignancy. Various materials and techniques have been utilized to restore stability and integrity to the chest wall. We report what we believe is the first use of a cadaveric Achilles tendon to restore stability and function to the chest wall of a young woman who underwent chest wall resection and right upper lobectomy for a superior sulcus tumor. Read More

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http://dx.doi.org/10.12659/AJCR.920910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077609PMC

The Novel Eryngii Method of Nipple Reduction for Female-to-Male Transsexuals.

Acta Med Okayama 2020 Feb;74(1):83-87

Department of Gender Center, Okayama University Hospital, Okayama 700-8558, Japan.

Mastectomy is usually the first and most important surgical procedure in female-to-male (FTM) individuals with gender identity disorder. Nipple reduction is also important in the process of reconstructing the chest wall for a more male appearance. If the nipples remain large after a mastectomy, the results may be disappointing to many FTM transsexuals. Read More

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http://dx.doi.org/10.18926/AMO/57958DOI Listing
February 2020

Rib Cage Stabilisation With 3D-Printed Polyethylene Sternal Prosthesis Post-Sternotomy Mediastinitis.

Heart Lung Circ 2020 Feb 13. Epub 2020 Feb 13.

Waikato District Health Board, Waikato Hospital Cardiothoracic Department, Hamilton, New Zealand.

Background: Post-sternotomy mediastinitis (PSM) is a serious complication of median sternotomy. It is associated with a high mortality rate. Evidence based management recommends debridement followed by closure with vascularised flaps. Read More

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http://dx.doi.org/10.1016/j.hlc.2020.01.005DOI Listing
February 2020

Bionic design and verification of 3D printed PEEK costal cartilage prosthesis.

J Mech Behav Biomed Mater 2020 Mar 20;103:103561. Epub 2019 Dec 20.

State Key Laboratory for Manufacturing System Engineering, Xi'an Jiaotong University, 710054, Xi'an, ShaanXi, China; School of Mechanical Engineering, Xi'an Jiaotong University, 710054, Xi'an, ShaanXi, China. Electronic address:

Chest wall reconstructions are mainly needed after surgical treatment of tumors or trauma. The costal cartilage is part of the chest wall, connecting sternum and ribs. The currently existing rib prostheses made of Titanium or PEEK were found lacking the costal cartilage portion, causing unsatisfactory functional rehabilitation of breath. Read More

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http://dx.doi.org/10.1016/j.jmbbm.2019.103561DOI Listing

Thoracic Wall Reconstruction: Surgical Planning in Extended Malignant Resections.

Ann Plast Surg 2020 Feb 19. Epub 2020 Feb 19.

From the Department of Plastic Surgery, Erasto Gaertner Hospital.

Introduction: The reconstruction of defects in thoracic wall remains a challenge for plastic surgeons. Advances in surgical treatment of illnesses of thoracic wall have been fostering the treatment of lesions within more advanced levels. Consequently, larger and more complex defects are generated, demanding soft tissue covering and framework repair. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002298DOI Listing
February 2020

Pilomatrix Carcinoma: A Rare Hair Cell Tumor.

Am Surg 2020 Jan;86(1):e38-e39

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January 2020

Extensive abdominal and chest wall resection and reconstruction for invasive squamous cell carcinoma of the skin.

J Thorac Dis 2020 Jan;12(1):45-49

Department of Cardiac-Thoracic Surgery, Vascular Sciences and Public Health, Division of Thoracic Surgery, University of Padua, Padua, Italy.

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http://dx.doi.org/10.21037/jtd.2019.08.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995819PMC
January 2020

Anterior chest wall resection and sternal body wedge for primary chest wall tumour: reconstruction technique with biological meshes and titanium plates.

J Thorac Dis 2020 Jan;12(1):17-21

Unit of Thoracic Surgery, Parini Hospital, Aosta, Italy.

Chest wall tumours are heterogeneous neoplasms, either primary or metastatic, with a malignancy rate of 50%. Surgical resection is one of the mainstays of the treatment, however, chest wall resections can be particularly challenging depending onto the resection size, site and patient habitus. The surgical strategy should be carefully analysed preoperatively, keeping in mind the need of an oncological radical resection (R0) in accordance to the reconstruction principles elicited by le Roux and Sherma since 1983, which include restoring the chest wall rigidity, preserving pulmonary mechanics, protect the intrathoracic organs, avoiding paradox movements of the chest cavity and, possibly, to reduce the thoracic deformity. Read More

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http://dx.doi.org/10.21037/jtd.2019.06.45DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995822PMC
January 2020

Sternochondral replacement: use of cadaveric allograft for the reconstruction of anterior chest wall.

J Thorac Dis 2020 Jan;12(1):3-9

Thoracic Surgery Unit, University Hospital of Padova, Padova, Italy.

Background: Sternum may be involved by different diseases such as trauma, infection after cardiac surgery, tumors (primary and secondary) or chest wall deformities. Surgical excision with a safety margin is the primary goal after sternal resection for tumors, prevention of respiratory impairment due to flail chest and deformity and protection of surrounding organs are other important aims. Various techniques and materials have been used for this operation. Read More

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http://dx.doi.org/10.21037/jtd.2019.07.82DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995821PMC
January 2020

Improving the Versatility of the Latissimus Dorsi Myocutaneous Flap Using the Perforator Propeller Flap Concept.

Ann Plast Surg 2020 Jun;84(6):689-696

Department of Oncological Orthopedics, Peking University People's Hospital, Peking University.

Background: The latissimus dorsi myocutaneous flap is widely used in reconstructive surgery; however, primary donor-site closure remains challenging when a wide flap is harvested.

Methods: A large latissimus dorsi myocutaneous flap was elevated and transferred to repair defects. Perforators adjacent to the donor site of the myocutaneous flap were explored using an ultrasound Doppler probe or a technique of extensive exploration along the margins of the donor site wound. Read More

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http://dx.doi.org/10.1097/SAP.0000000000002299DOI Listing

Cinematic rendering for three-dimensional reconstructions of the chest wall: a new reality.

Einstein (Sao Paulo) 2020 7;18:eMD5223. Epub 2020 Feb 7.

Cedars-Sinai S. Mark Taper Foundation Imaging Center, Los Angeles, CA, United States.

Computed tomography with multiple detectors and the advancement of processors improved rendered images and three-dimensional reconstructions in clinical practice. Traditional axial slices form non-intuitive images because they are seen in only one plane. The three-dimensional reconstructions can show structures details and diseases with complex anatomy in different perspectives. Read More

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http://dx.doi.org/10.31744/einstein_journal/2020MD5223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6999188PMC

Radiotherapy-related skin ulcer communicating with a left ventricular aneurysm.

Interact Cardiovasc Thorac Surg 2020 May;30(5):783-784

Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan.

Although radiation therapy is widely used to treat breast cancer, high doses of radiation may cause various complications. We report a case of a left ventricular aneurysm complicated with an intractable skin ulcer caused by radiation therapy for breast cancer. The communication between the aneurysm and skin ulcer caused severe bleeding. Read More

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http://dx.doi.org/10.1093/icvts/ivaa014DOI Listing

Successful pre-operative local control of skin exposure by sarcoma using combination of systemic chemotherapy and Mohs' chemosurgery.

World J Surg Oncol 2020 Feb 11;18(1):36. Epub 2020 Feb 11.

Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka, 545-8585, Japan.

Background: Sarcomas sometimes invade the skin and become exposed, producing malignant wounds characterized by bleeding, exudate, odor, and infection. Malignant cutaneous sarcomas are generally incurable and ultimately impair patients' quality of life. Mohs' chemosurgery is a previously published technique for chemical fixation of a cutaneous tumor and subsequent excision. Read More

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http://dx.doi.org/10.1186/s12957-020-01815-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014594PMC
February 2020

Prognostic factors following complete resection of non-superior sulcus lung cancer invading the chest wall.

Eur J Cardiothorac Surg 2020 Feb 10. Epub 2020 Feb 10.

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Objectives: Locally advanced non-small-cell lung cancer (NSCLC) with chest wall invasion carries a high risk of recurrence and portends poor survival (30-40% and 20-50%, respectively). No studies have identified prognostic factors in patients who underwent R0 resection for non-superior sulcus NSCLC.

Methods: A retrospective review was conducted for all chest wall resections for NSCLC from 2004 to 2018. Read More

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http://dx.doi.org/10.1093/ejcts/ezaa027DOI Listing
February 2020