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Forequarter amputation combined with chest wall resection: a single-center experience.

Identifieur interne : 002612 ( PubMed/Corpus ); précédent : 002611; suivant : 002613

Forequarter amputation combined with chest wall resection: a single-center experience.

Auteurs : Patrick Nierlich ; Philipp Funovics ; Martin Dominkus ; Oskar Aszmann ; Manfred Frey ; Walter Klepetko

Source :

RBID : pubmed:21619966

English descriptors

Abstract

Forequarter amputation combined with chest wall resection is a rarely performed procedure. Six patients were treated for advanced malignancies with this operation in our institution since 1993. Uncontrollable pain, lymphedema, loss of function of the affected limb and, in some patients, localized ulceration of the tumor at the time of presentation, provided the indication for the operation. All patients underwent radical amputation of the upper limb and the structures of the shoulder girdle, in combination with resection of the thoracic chest wall in an extent of 2 to 7 ribs.

DOI: 10.1016/j.athoracsur.2011.02.056
PubMed: 21619966

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pubmed:21619966

Le document en format XML

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<title xml:lang="en">Forequarter amputation combined with chest wall resection: a single-center experience.</title>
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<name sortKey="Nierlich, Patrick" sort="Nierlich, Patrick" uniqKey="Nierlich P" first="Patrick" last="Nierlich">Patrick Nierlich</name>
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<nlm:affiliation>Department of Cardiothoracic Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.</nlm:affiliation>
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<name sortKey="Funovics, Philipp" sort="Funovics, Philipp" uniqKey="Funovics P" first="Philipp" last="Funovics">Philipp Funovics</name>
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<name sortKey="Dominkus, Martin" sort="Dominkus, Martin" uniqKey="Dominkus M" first="Martin" last="Dominkus">Martin Dominkus</name>
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<name sortKey="Aszmann, Oskar" sort="Aszmann, Oskar" uniqKey="Aszmann O" first="Oskar" last="Aszmann">Oskar Aszmann</name>
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<name sortKey="Frey, Manfred" sort="Frey, Manfred" uniqKey="Frey M" first="Manfred" last="Frey">Manfred Frey</name>
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<name sortKey="Klepetko, Walter" sort="Klepetko, Walter" uniqKey="Klepetko W" first="Walter" last="Klepetko">Walter Klepetko</name>
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<term>Shoulder</term>
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<div type="abstract" xml:lang="en">Forequarter amputation combined with chest wall resection is a rarely performed procedure. Six patients were treated for advanced malignancies with this operation in our institution since 1993. Uncontrollable pain, lymphedema, loss of function of the affected limb and, in some patients, localized ulceration of the tumor at the time of presentation, provided the indication for the operation. All patients underwent radical amputation of the upper limb and the structures of the shoulder girdle, in combination with resection of the thoracic chest wall in an extent of 2 to 7 ribs.</div>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Forequarter amputation combined with chest wall resection is a rarely performed procedure. Six patients were treated for advanced malignancies with this operation in our institution since 1993. Uncontrollable pain, lymphedema, loss of function of the affected limb and, in some patients, localized ulceration of the tumor at the time of presentation, provided the indication for the operation. All patients underwent radical amputation of the upper limb and the structures of the shoulder girdle, in combination with resection of the thoracic chest wall in an extent of 2 to 7 ribs.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Chest wall reconstruction was achieved by implantation of a polytetrafluoroethylene patch (n=5) or a combination of a metal implant (Stratos System R, MedXpert GmbH, Heitersheim, Germany) and a polytetrafluoroethylene patch (n=1). Myocutaneous coverage of the defects was achieved by use of pedicled flaps from adjacent tissue (n=3) or by free myocutaneous flaps harvested from the amputated forearm (n=3).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">No perioperative mortality occurred; however, significant morbidity was seen after the use of the free forearm flaps based on occurring vascular problems. All 3 patients had to undergo surgical revision of the flap. Survival ranged from 5 to 50 months (median=23.5 months) with 3 patients still alive at the time of this investigation.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Forequarter amputation in combination with chest wall resection is a feasible and potentially curative treatment for malignant tumors of the shoulder girdle with invasion of the chest wall. The operation results in immediate palliation and long-term survival can be obtained in selected cases.</AbstractText>
<CopyrightInformation>Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
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