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Case Reports
. 2023 Mar 4;39(1):146.
doi: 10.1007/s00383-023-05413-1.

Clinical experience of thoracoplasty with absorbable rib substitutes

Juliana Mancera  1 , Viviana Echeverri  2   3 , Ana M Castillo  4 , Luis F Rodríguez  5 , Ricardo Zarama  5 , Carlos Villamil  5 , Juan P Luengas  2
Affiliations
Case Reports

Clinical experience of thoracoplasty with absorbable rib substitutes

Juliana Mancera et al. Pediatr Surg Int. .

Abstract

Purpose: Malignant chest wall tumors are rare in pediatrics. They require multimodal oncological treatment and local surgical control. Resections are extensive; therefore, thoracoplasty should be planned to protect intrathoracic organs, prevent herniation, future deformities, preserve ventilatory dynamics, and enable radiotherapy.

Methods: We present a case series of children with malignant chest wall tumors and our surgical experience with thoracoplasty using absorbable rib substitutes (BioBridge®), after local surgical control. BioBridge® is a copolymer made of a polylactide acid blend (70% L-lactic acid y 30% DL-lactide).

Results: In 2 years, we had three patients with malignant chest wall tumors. Resection margins were negative, without recurrence at follow-up. We achieved good cosmetic and functional results, and no postoperative complications.

Conclusion: Alternative reconstruction techniques such as absorbable rib substitutes provide protection, guarantee a flexible chest wall, and do not interfere with adjuvant radiotherapy. Currently, there are no management protocols in thoracoplasty. This option represents an excellent alternative for patients with chest wall tumors. Knowledge of different approaches and reconstructive principles is essential to offer children the best onco-surgical option.

Keywords: Absorbable prosthetic ribs; Chest wall tumors; Rib substitutes; Thoracoplasty.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
a Chest wall defect after en-bloc resection including residual fibrotic tissue in diaphragm and middle lung lobe. 1 cm Margins. b Primary reconstruction with a synthetic mesh and rib reconstruction with BioBridge®; soft tissue restoration with a latissimus dorsi flap. c Postoperative day 10. d 12 months after tumor resection and primary reconstruction
Fig. 2
Fig. 2
a 10 × 5 × 4 cm tumor dependent of the anterior portion of the third and fourth left ribs. b Primary reconstruction with a biosynthetic mesh and rib reconstruction with BioBridge®. c Postoperative day 8. d 1 month after tumor resection and primary reconstruction
Fig. 3
Fig. 3
a Chest wall defect after en-bloc resection, guaranteeing 1 cm margins. b, c Primary reconstruction with a synthetic mesh (non-absorbable) and rib arches with BioBridge®. d 2 months after tumor resection and primary reconstruction
See this image and copyright information in PMC

References

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