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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2014

01-05-2014 | Bone and Soft Tissue Sarcomas

Thoracopleuropneumonectomy with Riblike Reconstruction for Recurrent Thoracic Sarcomas

Authors: Ugo Pastorino, MD, Leonardo Duranti, MD, Paolo Scanagatta, MD, Francesco Leo, MD, Federico Piccioni, MD, Paola Collini, MD, Alessandro Gronchi, MD

Published in: Annals of Surgical Oncology | Issue 5/2014

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Abstract

Background

Large intrathoracic tumors may occasionally present with massive infiltration of the lung and chest wall that would require pneumonectomy and total removal of the rib cage to obtain radical surgical excision, but this operation carries a prohibitive risk of death for cardiopulmonary failure in the absence of adequate chest wall reconstruction.

Methods

We report here four consecutive cases of thoracopleuropneumonectomy (TPP) with en-bloc resection of the entire lung, chest wall, and diaphragm and immediate riblike reconstruction for recurrent thoracic sarcomas. Patients had undergone the initial thoracic surgical resection with curative intent 2–14 years before TPP. There was no postoperative mortality, and all patients were alive and free of disease 8–21 months after TPP.

Results

To our knowledge, this is the first report in the medical literature of such an extensive operation, demonstrating technical feasibility, tolerability, and efficacy of one-stage resection and reconstruction by a semirigid three-dimensional riblike prosthesis modeled on a human-derived aluminum cast.

Conclusions

Selected patients with advanced low-intermediate thoracic sarcomas are the ideal candidates for this extreme procedure, to maximize the chance of long-term tumor control and possibly cure.
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Metadata
Title
Thoracopleuropneumonectomy with Riblike Reconstruction for Recurrent Thoracic Sarcomas
Authors
Ugo Pastorino, MD
Leonardo Duranti, MD
Paolo Scanagatta, MD
Francesco Leo, MD
Federico Piccioni, MD
Paola Collini, MD
Alessandro Gronchi, MD
Publication date
01-05-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 5/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3485-0

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