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Chest Wall Reconstruction Using 3-Dimensional Printing: Functional and Mechanical Results

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Antonia Pontiki, Shruthi Natarajan, Fred N.H. Parker, Anvarjon Mukhammadaminov, Connor Dibblin, James Housden, Giulia Benedetti, Kawal Rhode, Andrea Bille

Original languageEnglish
JournalAnnals of Thoracic Surgery
DOIs
Published20 Sep 2021

Bibliographical note

Funding Information: Funded by the EPSRC Research Council, part of the EPSRC DTP, grant Ref: [EP/R513064/1]. Publisher Copyright: © 2021 The Society of Thoracic Surgeons

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Abstract

Background: Tumors involving the chest wall may require extensive resection and reconstruction. This study aims to evaluate functional, cosmetic results, and quality of life (QoL) in patients who had a reconstruction based on patient-specific 3-dimensional (3D) printing. Methods: The patient-specific chest wall prosthesis was created for 10 patients. The anatomical models were 3D printed and used to produce a silicone mold that was filled with methyl methacrylate to create the customized prosthesis. Evaluation of the reconstruction was completed with a QoL assessment and postoperative tracking of patients’ chest motion, using infrared markers. The distance between plot points representing markers on the operated and contralateral sides was measured to assess symmetrical motion. Results: Twenty-three consecutive patients were enrolled, with the median age of 64 years. Thirteen patients underwent a nonrigid reconstruction, and 10 had a patient-specific rigid reconstruction with methyl methacrylate. The median number of ribs resected was 3. No postoperative complications or morbidity related to the prostheses were reported. The median hospital stay in the nonrigid reconstruction group was 8.5 days compared with 7.5 days (p = .167) in the rigid reconstruction group. Postoperatively, most patients had low levels of symptoms, with 82% experiencing chest pain and 53% experiencing dyspnea. Rigid reconstruction patients demonstrated more symmetrical breathing motion compared with nonrigid reconstruction patients. The mean distances were 2.32 ± 2.18 and 7.28 ± 5.87 (P < .00001), respectively. Conclusions: This study shows that a 3D patient-specific prosthesis is feasible and safe, suggesting a possible trend toward improved breathing mechanics, QoL, and cosmetic results.

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