FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1997539548> ?p ?o ?g. }

• W1997539548 endingPage "e18" @default.
• W1997539548 startingPage "e17" @default.
• W1997539548 abstract "Among the new materials introduced for chest wall reconstruction, the use of collagen matrix is gaining increasing favor for its biomechanical properties. We describe the reconstruction of the chest wall with Veritas (Synovis, St Paul, MN) collagen matrix of a posterior chest wall defect after costovertebrectomy for Ewing's sarcoma. En bloc resection was performed, including partial D7 through D9 vertebrectomy along with the posterolateral segments of corresponding ribs. The collagen matrix patch was sutured to the spine stabilizer and the surrounding rib segments and was covered by previously raised latissimus dorsi and trapezius muscle flaps. Excellent stabilization was obtained. Among the new materials introduced for chest wall reconstruction, the use of collagen matrix is gaining increasing favor for its biomechanical properties. We describe the reconstruction of the chest wall with Veritas (Synovis, St Paul, MN) collagen matrix of a posterior chest wall defect after costovertebrectomy for Ewing's sarcoma. En bloc resection was performed, including partial D7 through D9 vertebrectomy along with the posterolateral segments of corresponding ribs. The collagen matrix patch was sutured to the spine stabilizer and the surrounding rib segments and was covered by previously raised latissimus dorsi and trapezius muscle flaps. Excellent stabilization was obtained. Consensus exists in proceeding to chest wall resection after chemotherapy for Ewing sarcoma [1Shamberger R.C. LaQuaglia M.P. Gebhardt M.C. et al.Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy.Ann Surg. 2003; 238: 563-567PubMed Google Scholar]. In this setting, challenging reconstruction can result from involvement of multiple vertebrae along with the variable lengths of the corresponding ribs. We describe the use of acellular collagen matrix as one of the materials of choice for chest wall reconstruction.TechniqueAn 18-year-old man was referred to our attention after the diagnosis of chest wall Ewing's sarcoma. The original lesion measured 9 × 7.5 × 6.5 cm, and was described as infiltrating the chest wall at the right costovertebral angle of D8, the posterior eighth rib, and the overlying adjacent paraspinal muscles (Fig 1A ). Four cycles of neoadjuvant chemotherapy (etoposide plus ifosfamide alternating to vincristine or adriamycin and cyclophosphamide) were administered yielding a significant reduction of the visible mass (down to 5 cm in greater diameter) (Fig 1B). At surgery, an en bloc resection of the posterior segments of ribs 7 to 9, along with partial vertebrectomy of the corresponding bodies was performed, and the spine was stabilized [2Yokomise H. Gotoh M. Okamoto T. et al.En bloc partial vertebrectomy for lung cancer invading the spine after induction chemoradiotherapy.Eur J Cardiothorac Surg. 2007; 31: 788-790Crossref PubMed Scopus (31) Google Scholar]. Although intraspinal ligation of the intercostal nerve roots was completed, a minimal tear of the dura was recognized and sealed with tissue glue (Fig 2). Given the site and geometrical characteristics of the defect, a 25 × 12 cm patch of acellular collagen matrix (Veritas, Synovis, St Paul, MN) was used as the sole reconstructive material. The patch was stretched and anchored to the stabilizer and to the surrounding ribs. Previously raised latissimus dorsi and trapezius muscle flaps were used to cover the patch, thus ensuring acceptable chest wall rigidity and tightness. The postoperative course was uneventful with the exception of an asymptomatic, contained cerebrospinal fluid leak, which was resolved without the need for reintervention. Two months after the surgery, a chest computed tomographic scan showed satisfactory postsurgical results (Fig 3). At 8 months after diagnosis, and after a 3-month follow-up from the operation, the patient was well and disease-free.Fig 2Intraoperative view of the surgical field after costovertebrectomy. The vertebral stabilizer is in place and tissue glue is on the exposed dura.View Large Image Figure ViewerDownload (PPT)Fig 3Chest computed tomographic scan on follow-up showing a satisfactory geometrical and structural outcome of chest wall resection and spinal reconstruction.View Large Image Figure ViewerDownload (PPT)CommentThe defect size and impinging of the scapula beneath the underlying ribs usually dictate the need for posterior chest wall reconstruction. However, chest wall resections, including concomitant vertebrectomy for Ewing's sarcoma and subsequent stabilization may pose challenging issues in young patients [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. Several new materials have been recently introduced in the clinical practice for coverage of chest wall defects [4Billè A. Gisabella M. Errico L. Borasio P. A suitable system of reconstruction with titanium rib prosthesis after chest wall resection for Ewing sarcoma.Interact Cardiovasc Thorac Surg. 2011; 12: 293-296Crossref PubMed Scopus (7) Google Scholar]. After chemotherapy, avoidance of foreign material may be advised for the risk of infection of pleura and subsequently, catastrophic extension to the spine. Acellular collagen matrix presents several biomechanical properties, which renders it use appealing for chest wall reconstruction [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. Incorporation in the host, resistance to infection and structural rigidity are already well-known features of the Veritas (Synovis) in breast or abdominal surgery [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. In addition, as in our case, elevation and repositioning of the muscle flap can add to the stability of the patch reconstruction [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. When vertebrectomy is performed, one issue that possibly compromises the tightness of the reconstruction is the absence of the usual bony or muscle tissue where it is anchoring the patch. In our patient, the vertebral stabilizer rod was successfully used to suture the acellular collagen matrix. An alternative reconstructive strategy could have been connecting the body of the sixth and tenth rib through titanium bars vertically locked into the ribs. However, to ensure chest wall stability, more than one rib bordering the defect should have been involved by rib locking to avoid inadvertent fractures of the bars or the ribs. Also, to argue against this possibility is the anatomical feature of the lowermost ribs, which presents a gradual splaying of their posterolateral course. In conclusion, among the innovative solutions for chest wall reconstruction, which are being applied to the clinical setting, the acellular collagen matrix represents a viable option for complex posterior defects. Consensus exists in proceeding to chest wall resection after chemotherapy for Ewing sarcoma [1Shamberger R.C. LaQuaglia M.P. Gebhardt M.C. et al.Ewing sarcoma/primitive neuroectodermal tumor of the chest wall: impact of initial versus delayed resection on tumor margins, survival, and use of radiation therapy.Ann Surg. 2003; 238: 563-567PubMed Google Scholar]. In this setting, challenging reconstruction can result from involvement of multiple vertebrae along with the variable lengths of the corresponding ribs. We describe the use of acellular collagen matrix as one of the materials of choice for chest wall reconstruction. TechniqueAn 18-year-old man was referred to our attention after the diagnosis of chest wall Ewing's sarcoma. The original lesion measured 9 × 7.5 × 6.5 cm, and was described as infiltrating the chest wall at the right costovertebral angle of D8, the posterior eighth rib, and the overlying adjacent paraspinal muscles (Fig 1A ). Four cycles of neoadjuvant chemotherapy (etoposide plus ifosfamide alternating to vincristine or adriamycin and cyclophosphamide) were administered yielding a significant reduction of the visible mass (down to 5 cm in greater diameter) (Fig 1B). At surgery, an en bloc resection of the posterior segments of ribs 7 to 9, along with partial vertebrectomy of the corresponding bodies was performed, and the spine was stabilized [2Yokomise H. Gotoh M. Okamoto T. et al.En bloc partial vertebrectomy for lung cancer invading the spine after induction chemoradiotherapy.Eur J Cardiothorac Surg. 2007; 31: 788-790Crossref PubMed Scopus (31) Google Scholar]. Although intraspinal ligation of the intercostal nerve roots was completed, a minimal tear of the dura was recognized and sealed with tissue glue (Fig 2). Given the site and geometrical characteristics of the defect, a 25 × 12 cm patch of acellular collagen matrix (Veritas, Synovis, St Paul, MN) was used as the sole reconstructive material. The patch was stretched and anchored to the stabilizer and to the surrounding ribs. Previously raised latissimus dorsi and trapezius muscle flaps were used to cover the patch, thus ensuring acceptable chest wall rigidity and tightness. The postoperative course was uneventful with the exception of an asymptomatic, contained cerebrospinal fluid leak, which was resolved without the need for reintervention. Two months after the surgery, a chest computed tomographic scan showed satisfactory postsurgical results (Fig 3). At 8 months after diagnosis, and after a 3-month follow-up from the operation, the patient was well and disease-free.Fig 3Chest computed tomographic scan on follow-up showing a satisfactory geometrical and structural outcome of chest wall resection and spinal reconstruction.View Large Image Figure ViewerDownload (PPT) An 18-year-old man was referred to our attention after the diagnosis of chest wall Ewing's sarcoma. The original lesion measured 9 × 7.5 × 6.5 cm, and was described as infiltrating the chest wall at the right costovertebral angle of D8, the posterior eighth rib, and the overlying adjacent paraspinal muscles (Fig 1A ). Four cycles of neoadjuvant chemotherapy (etoposide plus ifosfamide alternating to vincristine or adriamycin and cyclophosphamide) were administered yielding a significant reduction of the visible mass (down to 5 cm in greater diameter) (Fig 1B). At surgery, an en bloc resection of the posterior segments of ribs 7 to 9, along with partial vertebrectomy of the corresponding bodies was performed, and the spine was stabilized [2Yokomise H. Gotoh M. Okamoto T. et al.En bloc partial vertebrectomy for lung cancer invading the spine after induction chemoradiotherapy.Eur J Cardiothorac Surg. 2007; 31: 788-790Crossref PubMed Scopus (31) Google Scholar]. Although intraspinal ligation of the intercostal nerve roots was completed, a minimal tear of the dura was recognized and sealed with tissue glue (Fig 2). Given the site and geometrical characteristics of the defect, a 25 × 12 cm patch of acellular collagen matrix (Veritas, Synovis, St Paul, MN) was used as the sole reconstructive material. The patch was stretched and anchored to the stabilizer and to the surrounding ribs. Previously raised latissimus dorsi and trapezius muscle flaps were used to cover the patch, thus ensuring acceptable chest wall rigidity and tightness. The postoperative course was uneventful with the exception of an asymptomatic, contained cerebrospinal fluid leak, which was resolved without the need for reintervention. Two months after the surgery, a chest computed tomographic scan showed satisfactory postsurgical results (Fig 3). At 8 months after diagnosis, and after a 3-month follow-up from the operation, the patient was well and disease-free. CommentThe defect size and impinging of the scapula beneath the underlying ribs usually dictate the need for posterior chest wall reconstruction. However, chest wall resections, including concomitant vertebrectomy for Ewing's sarcoma and subsequent stabilization may pose challenging issues in young patients [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. Several new materials have been recently introduced in the clinical practice for coverage of chest wall defects [4Billè A. Gisabella M. Errico L. Borasio P. A suitable system of reconstruction with titanium rib prosthesis after chest wall resection for Ewing sarcoma.Interact Cardiovasc Thorac Surg. 2011; 12: 293-296Crossref PubMed Scopus (7) Google Scholar]. After chemotherapy, avoidance of foreign material may be advised for the risk of infection of pleura and subsequently, catastrophic extension to the spine. Acellular collagen matrix presents several biomechanical properties, which renders it use appealing for chest wall reconstruction [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. Incorporation in the host, resistance to infection and structural rigidity are already well-known features of the Veritas (Synovis) in breast or abdominal surgery [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. In addition, as in our case, elevation and repositioning of the muscle flap can add to the stability of the patch reconstruction [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. When vertebrectomy is performed, one issue that possibly compromises the tightness of the reconstruction is the absence of the usual bony or muscle tissue where it is anchoring the patch. In our patient, the vertebral stabilizer rod was successfully used to suture the acellular collagen matrix. An alternative reconstructive strategy could have been connecting the body of the sixth and tenth rib through titanium bars vertically locked into the ribs. However, to ensure chest wall stability, more than one rib bordering the defect should have been involved by rib locking to avoid inadvertent fractures of the bars or the ribs. Also, to argue against this possibility is the anatomical feature of the lowermost ribs, which presents a gradual splaying of their posterolateral course. In conclusion, among the innovative solutions for chest wall reconstruction, which are being applied to the clinical setting, the acellular collagen matrix represents a viable option for complex posterior defects. The defect size and impinging of the scapula beneath the underlying ribs usually dictate the need for posterior chest wall reconstruction. However, chest wall resections, including concomitant vertebrectomy for Ewing's sarcoma and subsequent stabilization may pose challenging issues in young patients [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. Several new materials have been recently introduced in the clinical practice for coverage of chest wall defects [4Billè A. Gisabella M. Errico L. Borasio P. A suitable system of reconstruction with titanium rib prosthesis after chest wall resection for Ewing sarcoma.Interact Cardiovasc Thorac Surg. 2011; 12: 293-296Crossref PubMed Scopus (7) Google Scholar]. After chemotherapy, avoidance of foreign material may be advised for the risk of infection of pleura and subsequently, catastrophic extension to the spine. Acellular collagen matrix presents several biomechanical properties, which renders it use appealing for chest wall reconstruction [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. Incorporation in the host, resistance to infection and structural rigidity are already well-known features of the Veritas (Synovis) in breast or abdominal surgery [5Shashidharan S. Karras R. Henry G. Use of Veritas acellular collagen matrix in chest wall reconstruction: an emerging choice.Am Surg. 2010; 76: 218-220PubMed Google Scholar]. In addition, as in our case, elevation and repositioning of the muscle flap can add to the stability of the patch reconstruction [3Gapany C. Raffoul W. Zambelli P.Y. Joseph J.M. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma.Pediatr Blood Cancer. 2009; 52: 679-681Crossref PubMed Scopus (10) Google Scholar]. When vertebrectomy is performed, one issue that possibly compromises the tightness of the reconstruction is the absence of the usual bony or muscle tissue where it is anchoring the patch. In our patient, the vertebral stabilizer rod was successfully used to suture the acellular collagen matrix. An alternative reconstructive strategy could have been connecting the body of the sixth and tenth rib through titanium bars vertically locked into the ribs. However, to ensure chest wall stability, more than one rib bordering the defect should have been involved by rib locking to avoid inadvertent fractures of the bars or the ribs. Also, to argue against this possibility is the anatomical feature of the lowermost ribs, which presents a gradual splaying of their posterolateral course. In conclusion, among the innovative solutions for chest wall reconstruction, which are being applied to the clinical setting, the acellular collagen matrix represents a viable option for complex posterior defects. The Veritas patch (Synovis, St. Paul, MN) was purchased through the funds of the National Italian Health System (Servizio Sanitario Nazionale) for use in this patient. The authors have no conflict of interest with the manufacturer and had full control of the study and production of this written report." @default.
• W1997539548 created "2016-06-24" @default.
• W1997539548 creator A5002665417 @default.
• W1997539548 creator A5006601034 @default.
• W1997539548 creator A5027326468 @default.
• W1997539548 creator A5031357021 @default.
• W1997539548 creator A5031452942 @default.
• W1997539548 creator A5032214110 @default.
• W1997539548 creator A5065577163 @default.
• W1997539548 creator A5072621298 @default.
• W1997539548 creator A5083692383 @default.
• W1997539548 date "2011-07-01" @default.
• W1997539548 modified "2023-09-23" @default.
• W1997539548 title "The Use of Veritas Collagen Matrix to Reconstruct the Posterior Chest Wall After Costovertebrectomy" @default.
• W1997539548 cites W1996548890 @default.
• W1997539548 cites W2044954157 @default.
• W1997539548 cites W2083168890 @default.
• W1997539548 cites W2138841841 @default.
• W1997539548 cites W2419186480 @default.
• W1997539548 doi "https://doi.org/10.1016/j.athoracsur.2011.02.080" @default.
• W1997539548 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21718821" @default.
• W1997539548 hasPublicationYear "2011" @default.
• W1997539548 type Work @default.
• W1997539548 sameAs 1997539548 @default.
• W1997539548 citedByCount "14" @default.
• W1997539548 countsByYear W19975395482012 @default.
• W1997539548 countsByYear W19975395482013 @default.
• W1997539548 countsByYear W19975395482014 @default.
• W1997539548 countsByYear W19975395482015 @default.
• W1997539548 countsByYear W19975395482016 @default.
• W1997539548 countsByYear W19975395482017 @default.
• W1997539548 crossrefType "journal-article" @default.
• W1997539548 hasAuthorship W1997539548A5002665417 @default.
• W1997539548 hasAuthorship W1997539548A5006601034 @default.
• W1997539548 hasAuthorship W1997539548A5027326468 @default.
• W1997539548 hasAuthorship W1997539548A5031357021 @default.
• W1997539548 hasAuthorship W1997539548A5031452942 @default.
• W1997539548 hasAuthorship W1997539548A5032214110 @default.
• W1997539548 hasAuthorship W1997539548A5065577163 @default.
• W1997539548 hasAuthorship W1997539548A5072621298 @default.
• W1997539548 hasAuthorship W1997539548A5083692383 @default.
• W1997539548 hasConcept C105702510 @default.
• W1997539548 hasConcept C106487976 @default.
• W1997539548 hasConcept C126838900 @default.
• W1997539548 hasConcept C159985019 @default.
• W1997539548 hasConcept C192562407 @default.
• W1997539548 hasConcept C71924100 @default.
• W1997539548 hasConceptScore W1997539548C105702510 @default.
• W1997539548 hasConceptScore W1997539548C106487976 @default.
• W1997539548 hasConceptScore W1997539548C126838900 @default.
• W1997539548 hasConceptScore W1997539548C159985019 @default.
• W1997539548 hasConceptScore W1997539548C192562407 @default.
• W1997539548 hasConceptScore W1997539548C71924100 @default.
• W1997539548 hasIssue "1" @default.
• W1997539548 hasLocation W19975395481 @default.
• W1997539548 hasLocation W19975395482 @default.
• W1997539548 hasOpenAccess W1997539548 @default.
• W1997539548 hasPrimaryLocation W19975395481 @default.
• W1997539548 hasRelatedWork W1506200166 @default.
• W1997539548 hasRelatedWork W1995515455 @default.
• W1997539548 hasRelatedWork W2048182022 @default.
• W1997539548 hasRelatedWork W2049214470 @default.
• W1997539548 hasRelatedWork W2080531066 @default.
• W1997539548 hasRelatedWork W2748952813 @default.
• W1997539548 hasRelatedWork W2899084033 @default.
• W1997539548 hasRelatedWork W3031052312 @default.
• W1997539548 hasRelatedWork W3032375762 @default.
• W1997539548 hasRelatedWork W3108674512 @default.
• W1997539548 hasVolume "92" @default.
• W1997539548 isParatext "false" @default.
• W1997539548 isRetracted "false" @default.
• W1997539548 magId "1997539548" @default.
• W1997539548 workType "article" @default.