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Göğüs Ön Duvarı Defektlerinde Göğüs Cerrahisi ile Birlikte Rekonstrüksiyon Deneyimlerimiz
2015
Journal:  
Gazi Medical Journal
Author:  
Abstract:

Göğüs ön duvarı rekonstrüksiyonu; akciğerlerin fizyolojik fonksiyonunu ve ekspansiyonunu sağlamak amacıyla hem iskelet hem de hava kaçışını engelleyen doku komponentleri düşünülerek planlanmalıdır. Tümör, enfeksiyon, travma vb. nedenlerle oluşan göğüs ön duvarı defektlerinde; öncelikle iskelet stabilizasyonunun sağlanmasını takiben iyi vaskülerize bir yumuşak doku örtüsü gerekmektedir. Göğüs ön duvarı defektlerinde sıklıkla pektoralis majör flebi, serratus anterior flebi, eksternal oblik kas flebi, rektus abdominus flebi, latisimus dorsi flebi, omental flep gibi kas, kas-deri flepleri kullanılmaktadır. Göğüs ön duvarında defekti olan 8 hastanın Göğüs Cerrahisi Kliniği ile birlikte; her biri için defektlerine uygun rekonstrüksiyon planlanladığımız klinik deneyimlerimizi paylaşmayı amaçladık.  2012-2013 tarihleri arasında kliniğimize ve göğüs cerrahisi kliniğine başvuran 3’ü kadın 5’i erkek 8 hastanın göğüs ön duvarı defektleri  latisimus dorsi ve pektoralis majör kas deri flebi ile rekonstrüksiyonu sağlandı. 4 hastada titanyum plak ve mesh ile yeni göğüs duvarı oluşturuldu. Meme CA sonrası radyoterapi alan 2 hastaya latisimus dorsi kas deri flebi ile sternumda osteosarkomu olan 1 hasta önce bilateral pektoralis majör kas deri flebi ile flepte dehissens gelişmesi üzerine latisimus dorsi flebi ile 2 hasta tek taraflı pektoralis majör kas deri flebi ile 3 hasta ise bilateral pektoralis majör kas deri flebi ile rekonstrükte edildi. Göğüs ön duvarı defekti olan her hastanın kendi içinde değerlendirilerek hastaya en uygun olan rekonstrüksiyon planının seçilmesi gerekmektedir. Bizim vakalarımızda da her hasta için hastaya özel rekonstrüksiyon seçeneği tercih edilmiştir. Tüm hastaların farklı farklı olan defektlerinin rekonstrüksiyonları uygun cerrahi planlanarak yapılmış olup; fonksiyonel ve estetik olarak sonuçlar tatmin edici bulunmuştur.  

Keywords:

Our Breast Front Wall Defects with Breast Surgery with Reconstruction Experiences
2015
Author:  
Abstract:

The reconstruction of the front wall of the chest should be planned by considering the tissue components that prevent both the skeletal and air leakage in order to ensure the physiological function and expansion of the lungs. tumor, infection, trauma, etc. In the defects of the front wall of the chest formed by causes; first of all, after the stabilization of the skeletal is required a soft tissue cover for your good vessels. In the front wall defects of the chest are often used muscle, muscle-leather fleps such as pektoralis major flebi, serratus anterior flebi, external shape muscle flebi, rektus abdominus flebi, latisimus dorsi flebi, omental flep. Together with the Breast Surgery Clinic of 8 patients with a defect in the front wall of the chest, we aimed to share our clinical experiences we planned to reconstruct according to their defects for each.  Between 2012-2013, 3 women, 5 men, 8 patients, who appealed to our clinic and breast surgery clinic, were provided with breast front wall defects with latisimus dorsi and pektoralis major muscle skin flebi. In 4 patients, a new breast wall was created with titanium plate and mesh. 2 patients with latisimus dorsi skin flebi with sternumda osteosarcomu with 1 patient with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with latisimus dorsi skin flebi with 2 patients with 2 patients with 2 patients with 2 patients with 2 patients with 2 patients with 2 patients with Each patient with the front wall defect should be assessed in his own and the patient's most suitable reconstruction plan should be chosen. In our cases, a special reconstruction option is preferred for each patient. The reconstructions of the different defects of all patients were performed by appropriate surgical planning; functional and aesthetic results were found satisfying.

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Gazi Medical Journal

Field :   Sağlık Bilimleri

Journal Type :   Uluslararası

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Gazi Medical Journal