Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2020;27(03):268-273

Clinical application of 3D printed titanium chest and rib implants in chest wall reconstruction

ZHANG Hao 1 ; HUANG Lijun 1 ; ZHU Yifang 1 ; YANG Sanhu 1 ; LIU Xi 1 ; CAO Tiesheng 2 ; LIANG Jiahe 2 ; GUO Yitong 2 ; WANG Lei 1 ; LI Xiaofei 1

Affiliations

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Keywords

Three-dimensional printing; titanium; chest wall reconstruction

Country

China

Language

Chinese

Abstract

Objective    In this study, three-dimensional printed (3DP) titanium implants were used for skeletal reconstructions after wide excision of chest wall. 3DP titanium implants were expected to provide a valid option with perfect anatomic fitting and personalized design in chest wall reconstruction. Methods    There were 13 patients [mean age of 46 (24-78) years with 9 males and 4 females] who underwent adequate radical wide excision for tumors and chest wall reconstruction using 3DP titanium implants. Surgical data including patient demographic characteristics, perioperative clinical data and data from 1-year follow-up were collected and analyzed. Results    Six patients of rib tumors, six patients of sternal tumors and one patient of sternal pyogenic osteomyelitis were finally selected for the study. The chest wall defect area was 221.0±206.0 cm2. All patients were able to maintain the integrity of the chest wall after surgery, and no abnormal breathing was found, achieving personalized and anatomical repair. Thirteen patients were successfully discharged from the hospital. Two patients developed pneumonia in the perioperative period. During the follow-up period in the first year after surgery, no implant related adverse reaction was observed, including implant rupture, implant shift, rejection reaction and allergies. One patient had wound ulcer after chemotherapy. Three patients had tumor recurrence, with the recurrence rate of 25.0%. Two patients died of tumor recurrence, with a mortality rate of 16.7%. Conclusion    3DP titanium implant is a safe and effective material for chest wall reconstruction.