Release date: 2017-11-06

Recently, a doctor from Tianjin Hospital successfully conducted the first “3D-printed functional reconstruction of a customized prosthesis for 3D-printed sternal stem malignant tumor resection” for a 56-year-old man from Heilongjiang Province, which has grown into an adult for many years. A fist-sized rare sternal stem chondrosarcoma with a 3D printed custom prosthesis that combines strength, individuality, and histocompatibility, completely retaining the patient's bilateral sternosacral joint, shoulder joint, and upper limb function. It is understood that such surgical methods and reconstruction methods have not been reported in the literature in China.

The patient was hit by a tricycle handlebar 20 years ago, accompanied by sternal pain, but did not care as the pain disappeared. Seven years ago, he found an inflated bag in front of the sternum, but it was still untreated because there was no obvious swelling and pain. Four months ago, the mass increased significantly with local pain and increased after the event. He went to the Tianjin Hospital for Cardiothoracic Surgery and was diagnosed as a sternal stem chondrosarcoma. The tumor has reached the size of a fist.

According to Wang Dongbin, director of the department, surgical resection is the first choice for the treatment of sternal tumors, but the incidence of sternal chondrosarcoma is low, but the literature is very rare, and the operation is quite difficult: first, the sternum stem is adjacent to the two sides of the clavicle, costal cartilage There is no activity in the mass. It is difficult to complete the resection of such a huge malignant mass. Second, the aortic arch and its branches and the left brachiocephalic vein behind the tumor are under pressure, indicating that the tumor may involve large blood vessels. There is a fatal risk of major bleeding during surgery. Third, after the sternal stem and mass are removed together, a huge defect will be formed between the bilateral clavicle and the sternum, which will cause softening and collapse of the anterior chest wall, impaired thoracic activity and upper limbs and shoulders. Part of the activity barrier, the quality of life of patients will be greatly affected.

During the operation, the doctor carefully operated and carefully dissected and treated the blood vessels. The tumor and the blood vessels under the pressure were successfully separated one by one, and the tumor was completely removed. The 3D printing technique was used to simulate the shape, size and thickness of the patient's own sternum. Body, used to repair the chest wall defect after sternal stem resection, restore chest wall integrity. In addition, in order to help patients save the cost of surgery, the patient's autologous tendon was used to reconstruct the sterno-lock joint, which maximized the shoulder and upper limb function of the patient and realized the functional reconstruction of the bony thorax. The patient recovered smoothly after surgery, and the appearance and limb function were the same as those of ordinary people.

Source: Tianjin Daily

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