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Int J Surg Case Rep 2021 Apr 27;82:105908. Epub 2021 Apr 27.

Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Hokkaido, Japan.

Introduction: Necrotizing soft tissue infection (NSTI) of the chest wall is a rare, rapidly spreading, highly lethal surgical disease. Radical debridement interferes with the important anatomical function of the chest wall. We report a case of chest wall NSTI that was successfully managed with early diagnosis and serial debridement. Read More

Plast Reconstr Surg 2021 May 6. Epub 2021 May 6.

Breast Surgery Cambridge University Hospitals Cambridge, United Kingdom.

Plast Reconstr Surg 2021 May 6. Epub 2021 May 6.

Department of Radiation Oncology The University of Texas M. D. Anderson Cancer Center Houston, Texas.

Chirurgia (Bucur) 2021 Mar-Apr;116(2):224-231

Background And Objectives: Nowadays, breast cancer treatment spans from simple lesion excision to complex management including surgery (mastectomy with or without axillary lym-phadenectomy) and adjuvant treatment (chemotherapy, radiotherapy, hormonal therapy and im-munotherapy). Lately, breast reconstruction has become part of the breast cancer approach, but, while its physical and emotional benefits are undisputed, it comes with its own set of risks and complications, especially when delayed breast reconstruction after radiotherapy is performed. This paper aims to present our experience on the effects of radiotherapy in conjunction with de-layed alloplastic breast reconstruction. Read More

Asian Cardiovasc Thorac Ann 2021 May 4:2184923211014004. Epub 2021 May 4.

Department of Surgery, Universiti Malaya, Kuala Lumpur, Malaysia.

We present a 14-year-old boy with Loey-Dietz syndrome with severe mitral regurgitation, pectus excavatum and scoliosis. The Haller index was 25. The heart was displaced into the left hemithorax. Read More

Cureus 2021 Mar 30;13(3):e14185. Epub 2021 Mar 30.

Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.

Discovery and variations of rectus sternalis muscle are occasionally seen in humans. However, during routine academic dissection of an adult male embalmed cadaver, a rare variant of the muscle was identified. The muscle had origin from the pectoral muscle and fascia and was inserted into external oblique aponeurosis along with the sixth rib and cartilage. Read More

Eur J Surg Oncol 2021 Apr 13. Epub 2021 Apr 13.

Honorary Senior Lecturer, Birmingham University, Consultant Oncoplastic Surgeon, The Royal Wolverhampton NHS Trust, England, UK.

The use of chest wall perforator flaps (CWPFs) following breast conservation surgery for breast cancer has become a useful tool in the armamentarium of the oncoplastic breast surgeon, however robust evidence for the technique is lacking. The aim of this study was to conduct a systematic review appraising the current evidence for the use of CWPFs, evaluating clinical, oncological and cosmetic outcomes. A PRISMA-compliant systematic review, with PROSPERO published protocol a priori and search of all relevant database and trial registries between 1990 to July 2020. Read More

Phys Med Biol 2021 Apr 23. Epub 2021 Apr 23.

Radiology and Electrical Engineering, Washington University in Saint Louis, Saint Louis, Missouri, UNITED STATES.

This paper presents a novel PET geometry for breast cancer imaging. The scanner consists of a "stadium" shaped ring, along with anterior and posterior panels to provide high sensitivity and high spatial resolution for an imaging field-of-view (FOV) that include both breasts, mediastinum and axilla. We simulated this total-breast PET system using GATE, and reconstructed the coincidence events using a GPU-based list-mode image reconstruction implementing maximum likelihood expectation-maximization (ML-EM) algorithm. Read More

Plast Reconstr Surg 2021 May;147(5):1059-1061

From the Division of Plastic and Reconstructive Surgery, University of Montreal Hospital Center; and the Division of Plastic and Reconstructive Surgery, University of Iowa Hospitals and Clinics.

Summary: One key component of a successful autologous breast reconstruction is insetting the flap to accurately resemble an aesthetic breast. The authors describe a novel technique used to shape a deep inferior epigastric artery perforator flap into a coned breast mound before introducing it into the breast pocket. With the flap perfusing on the chest wall, an area of skin estimating the size and location of the skin paddle is marked. Read More

Int J Surg Case Rep 2021 Apr 16;81:105777. Epub 2021 Mar 16.

Resident of Orthopaedic and Traumatology, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

Introduction And Importance: Chest wall tumour could grow from various tissues composing the chest wall. Diagnosis and treatment of patients with chest wall tumour pose several challenges.

Case Presentation: We present a case of 55 year old woman with chief complaint of a painfull mass on her chest wall. Read More

Ann Thorac Surg 2021 Apr 18. Epub 2021 Apr 18.

Department of Cardiothoracic surgery, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

We present a case of a 74-year-old male patient, with a history of a squamous cell carcinoma in the left axilla. The patient underwent a multidisciplinary surgical resection through an extended forequarter amputation with thoracic wall resection and reconstruction. With regard to the complexity of the case, 3D virtual reality-based patient-specific reconstructions were used as a supplemental tool to conventional computed tomography-imaging in order to plan the procedure. Read More

Plast Reconstr Surg 2021 May;147(5):879e-880e

Department of Plastic Surgery, Division of Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Plast Reconstr Surg 2021 May;147(5):878e-879e

Division of Plastic and Reconstructive Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Academic Hospital, Francie van Zijl Drive, P.O. Box 241, Cape Town, Tygerberg 8000, South Africa,

World J Clin Cases 2021 Apr;9(10):2302-2311

Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City 40454, Taiwan.

Background: Chondrosarcoma, a cartilage matrix producing tumor, is the second most commonly observed primary bone tumor after osteosarcoma, accounting for 15% of all chest wall malignancies. We herein report the case of a patient with chondrosarcoma of the sternum and our management of the chest wall defects that presented following radical tumor resection.

Case Summary: A 31-year-old patient presented to our hospital with dull pain and a protruding mass overlying the chest for 3 mo. Read More

BMC Musculoskelet Disord 2021 Apr 12;22(1):348. Epub 2021 Apr 12.

Musculoskeletal Tumor Center, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.

Background: En bloc resection of malignant tumors involving upper thoracic spine is technically difficult. We surgically treated a patient with grade 2 chondrosarcoma involving T1-5, left upper thoracic cavity, and chest wall.

Case Presentation: A 37 years old, male patient was referred to our hospital for a huge lump involved left shoulder and chest wall. Read More

Aesthetic Plast Surg 2021 Apr 5. Epub 2021 Apr 5.

Blizard Institute, Barts and The London School of Medicine and Dentistry, Centre for Cutaneous Research, 4 Newark Street, London, E1 2AT, UK.

Background: Enhanced Recovery After Surgery (ERAS) pathways are known to improve patient outcomes after surgery. In recent years, there have been growing interest in ERAS for reconstructive surgery.

Objectives: To systematically review and summarise literature on the key components and outcomes of ERAS pathways for autologous flap-based reconstruction. Read More

Indian J Plast Surg 2021 Jan 20;54(1):82-85. Epub 2020 Aug 20.

Department of Surgery, University of Nairobi, Nairobi, Kenya.

Dermato-fibro-sarcomas are known for high-recurrence rates. The gold standard of management is surgical excision with clear margins. Such margins on the chest results in large defects which require complex reconstructive procedures. Read More

Ann Thorac Surg 2021 Mar 31. Epub 2021 Mar 31.

Department of Thoracic Surgery, Medical University of Vienna, Austria.

Lung transplantation (LTx) is an established treatment for a variety of end-stage lung diseases, however, chest wall deformities such as an asymmetric pectus excavatum are often considered a contraindication for LTx. Consequently, the published experience of LTx and simultaneous chest wall reconstruction is limited to a few case reports only. This article aims to provide a detailed description of surgical steps as well as technical challenges and pitfalls of LTx with a simultaneous modified Ravitch procedure. Read More

Front Pediatr 2021 15;9:661025. Epub 2021 Mar 15.

Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.

Ewing sarcomas of the chest wall, historically known as "Askin tumors" represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical "en-bloc" resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels. Read More

Turk Gogus Kalp Damar Cerrahisi Derg 2021 Jan 13;29(1):122-125. Epub 2021 Jan 13.

Department of Thoracic Surgey, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey.

It is a challenging issue for thoracic surgeons to repair and reconstruct large defects after chest wall resection without disturbing pulmonary functions. Currently, it is possible to produce nearly the same prosthesis anatomically as the original with the three-dimensional printer technology. Titanium-alloy prostheses produced with the three-dimensional prototyping technology by selective laser sintering technique meet the sensitive needs of reconstruction without impairing the functionality of the tissue. Read More

JPRAS Open 2021 Jun 7;28:56-60. Epub 2021 Feb 7.

Clinic of Plastic and Reconstructive Surgery, Department of Experimental and Clinical Medicine, Marche Polytechnic University Medical School, Ancona, Italy.

Lung hernia following minimally invasive cardiac surgery is rare with few reported cases in the literature. Surgical repair is debated, and several methods have been described including a variety of synthetic and biological materials. We report a case of a 36-year-old woman who developed lung hernia and a strong retraction of the pectoralis major muscle after minithoracotomy that was performed for mitral valve surgery. Read More

Medicine (Baltimore) 2021 Mar;100(10):e24033

Department of Ultrasound.

Introduction: One of the purposes of echocardiography is to determine the nature of a space-occupying lesion. The conventional transthoracic echocardiogram (TTE) is the preferred method for the diagnosis of cardiac space-occupying lesions as it can reveal the baseline information. For patients with poor conditions, however, TTE cannot clearly display the boundary, it has a limited role in determining the nature of the lesions. Read More

Zhonghua Xin Xue Guan Bing Za Zhi 2021 Mar 24;49(3):229-235. Epub 2021 Mar 24.

Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

To analyze the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves by three-dimensional electrophysiological technique in patients with atrial fibrillation (AF), and to investigate the efficacy and safety of segmental radiofrequency catheter ablation (RFCA) for isolation of superior vena cava in these patients In this retrospective study, we enrolled 136 AF patients who underwent first RFCA in the First Affiliated Hospital of Zhengzhou University from July 2018 to June 2019 and all patients underwent SVC isolation under sinus rhythm. Baseline clinical data of patients were collected. The functional sinus node was defined by activation mapping, pacing was guided by three-dimensional mapping (Carto) system, localization of the right phrenic nerve was defined by pacing map, the superior vena cava-right atrial muscle sleeves was determined according to the change of potential during SVC isolation, segmental RFCA was performed for SVC isolation, the three-dimensional distribution of functional sinus node, right phrenic nerve and superior vena cava(SVC)-right atrial muscle sleeves was determined by three-dimensional electrophysiological technique. Read More

Monaldi Arch Chest Dis 2021 Mar 8. Epub 2021 Mar 8.

Department of Thoracic Surgery, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Desmoid tumours are rare, locally aggressive neoplasms exhibiting high tendency for recurrence, even after complete resection. Only 1 in 5 of them originates from the chest wall, usually measuring less than 10 cm at diagnosis. Herein, we report the case of a woman presenting with symptoms of gradual lung compression by a giant desmoid tumour occupying the entire hemithorax. Read More

Ann Thorac Surg 2021 Mar 6. Epub 2021 Mar 6.

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address:

Tumors involving the sternum often require complete removal of the bony structure to achieve cure and prevent recurrence. The type and extent of reconstruction must be carefully selected. Full-thickness sternal defects often necessitate semirigid or rigid biocompatible prostheses and carefully transposed myocutaneous flaps. Read More

Plast Reconstr Surg Glob Open 2021 Feb 17;9(2):e3400. Epub 2021 Feb 17.

Department of Plastic and Reconstructive Surgery, University Hospitals Birmingham Foundation Trust, Birmingham, United Kingdom.

The anterioabdominal wall is the most common site for low molecular weight heparin administration for anticoagulation, either for prophylactic or for therapeutic indications. Occasionally, this could be associated with damage of the abdominal pannus microvasculature, which could possibly jeopardize the reliability of free abdominal flaps as deep inferior epigastric perforator and muscle sparing transverse rectus abdominis muscle, especially with therapeutic anticoagulation therapy. These flaps are reliant on a highly intricate complex vascular anatomy and perforasomes for their adequate perfusion and survival. Read More

Trauma Case Rep 2021 Apr 10;32:100415. Epub 2021 Feb 10.

Department of Anesthesiology, University of Texas Health Science Center at Houston, 6411 Fannin Street, Houston 77030, United States of America.

Data Brief 2021 Apr 5;35:106837. Epub 2021 Feb 5.

Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

Nipple-spring mastectomy (NSM) with immediate breast reconstruction is being increasingly used in the treatment of breast cancer [1]. However, there are limited available data on the prognostic implications of locoregional recurrence (LRR) following this surgical procedure. This article is a supplementary resource of the original research article by Wu ZY et al. Read More

Int J Surg Case Rep 2021 Mar 18;80:105663. Epub 2021 Feb 18.

Department of Thoracic Surgery, Ibn Rochd-Casablanca University Hospital Center, Morocco; Hassan 2 University of Casablanca, Morocco. Electronic address:

Introduction: Papillary thyroid carcinomas (PTC) are differentiated forms of thyroid carcinoma. Sternal metastases from differentiated thyroid cancers (DTCs) are rare and are of particular prognostic interest. Radioiodine therapy has traditionally been the treatment of choice for metastases from differentiated thyroid cancers; however, bone metastases are known to be resistant to this form of treatment. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Feb;35(2):200-205

Scar Comprehensive Treatment Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, P.R.China.

Objective: To explore the feasibility of using indocyanine green (ICG) angiography to detect brachial artery perforators, and the clinical application of brachial artery perforator propeller (BAPP) flaps to repair soft tissue defects of the trunk and upper limbs.

Methods: Between August 2016 and February 2019, ICG angiography was used to detect the perforating vessels of the brachial artery muscle septum, and the BAPP flaps were cut out with the detected perforating vessels as the pedicle to repair 19 cases of trunk and upper limb soft tissue defects. There were 12 males and 7 females, with an average age of 28. Read More