The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
Adrien Daigeler - One of the best experts on this subject based on the ideXlab platform.
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Thoracic Wall reconstruction after tumor resection
Frontiers in oncology, 2015Co-Authors: Kamran Harati, Jonas Kolbenschlag, Björn Behr, Ole Goertz, Tobias Hirsch, Nicolai Kapalschinski, Andrej Ring, Marcus Lehnhardt, Adrien DaigelerAbstract:Introduction: Surgical treatment of malignant Thoracic Wall tumors represents a formidable challenge. In particular, locally advanced tumors that have already infiltrated critical anatomic structures are associated with a high surgical morbidity and can result in full thickness defects of the Thoracic Wall. Plastic surgery can reduce this surgical morbidity by reconstructing the Thoracic Wall through various tissue transfer techniques. Sufficient soft tissue reconstruction of the Thoracic Wall improves life quality and mitigates functional impairment after extensive resection. The aim of this article is to illustrate the various plastic surgery treatment options in the multimodal therapy of patients with malignant Thoracic Wall tumors. Material und methods: This article is based on a review of the current literature and the evaluation of a patient database. Results: Several plastic surgical treatment options can be implemented in the curative and palliative therapy of patients with malignant solid tumors of the chest Wall. Large soft tissue defects after tumor resection can be covered by local, pedicled or free flaps. In cases of large full-thickness defects, flaps can be combined with polypropylene mesh to improve chest Wall stability and to maintain pulmonary function. The success of modern medicine has resulted in an increasing number of patients with prolonged survival suffering from locally advanced tumors that can be painful, malodorous or prone to bleeding. Resection of these tumors followed by Thoracic Wall reconstruction with viable tissue can substantially enhance the life quality of these patients. Discussion: In curative treatment regimens, chest Wall reconstruction enables complete resection of locally advanced tumors and subsequent adjuvant radiotherapy. In palliative disease treatment, stadium plastic surgical techniques of Thoracic Wall reconstruction provide palliation of tumor-associated morbidity and can therefore improve patient quality of life.
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Thoracic Wall Reconstruction in Advanced Breast Tumours.
Geburtshilfe und Frauenheilkunde, 2014Co-Authors: Adrien Daigeler, Kamran Harati, Björn Behr, Ole Goertz, Tobias Hirsch, Marcus Lehnhardt, Jonas KolbenschlagAbstract:In advanced mammary tumours, extensive resections, sometimes involving sections of the Thoracic Wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large Thoracic Wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of Thoracic Wall resection on the respiratory mechanism can be easily compensated for and patientsʼ quality of life in the palliative stage of disease can often be improved.
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reconstruction of the Thoracic Wall long term follow up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare.
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Reconstruction of the Thoracic Wall—long-term follow-up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare. Materials and methods The data of 92 consecutive patients with full thickness chest Wall resections were acquired from patient’s charts and contact to patients, their relatives or general practitioners, with special reference to treatment and clinical course. At a mean follow-up of 5.5 years, 36 patients were examined physically and interviewed. Twenty-seven of them underwent additional pulmonary function tests. Kaplan–Meier method was used to calculate survival. Regression tests were undertaken to identify factors influencing the outcome. Results Postoperative complications were observed in 42.4%, but neither mesh implantation nor the size of the defect contributed significantly. The 5-year mortality was worse for patients with recurrent mamma carcinoma (90.6%) than for patients with soft tissue sarcoma (56.3%). No medical history or operation parameter (resection size and localization) besides the general patients’ conditions increased mortality. Pulmonary function parameters were only moderately reduced and not significantly affected by the resections’ size or its localization. Majority of patients suffer from sensation disorders and motion-dependent pain, which contributed significantly to hypoxemia. Quality-of-life parameters were significantly reduced compared to the healthy control group but similar to the control group with cancer according to the Short Form-36 protocol. We could not detect a relevant decrease in quality of life comparing post- to preoperative values. Conclusions Thoracic Wall reconstruction provides sufficient Thoracic Wall stability to maintain pulmonary function, but postoperative pain and sensation disorders are considerable. However, chest Wall repair can contribute to palliation and even cure after full-thickness resections.
Ki Jinn Chin - One of the best experts on this subject based on the ideXlab platform.
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erector spinae plane block for surgery of the posterior Thoracic Wall in a pediatric patient
Regional Anesthesia and Pain Medicine, 2017Co-Authors: Maria A Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn ChinAbstract:Objective Historically, regional anesthesia for surgery on the posterior Thoracic Wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior Thoracic Wall. We report the use of the ESP block for this clinical application in a pediatric patient. Case Report A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4–T7 dermatomes. She received a preoperative single-shot ESP block at the level of the T1 transverse process; this level was chosen to avoid the lipoma and cover the planned surgical incision over the T2–T8 dermatomes. Hemodynamic stability and excellent pain control perioperatively were obtained with minimal anesthetic requirements and no systemic analgesics apart from fentanyl administered for induction of anesthesia. Return to normal function (ambulation, feeding, and communication) was achieved within 2 hours after surgery. A pain score of 0 on the FLACC (Face, Legs, Activity, Cry, Consolability) scale was maintained until discharge from the hospital 4 hours after the surgery. First analgesic use was 18 hours after hospital discharge. No complications were reported. Conclusions The ESP block is an effective option for surgery on the posterior Thoracic Wall. The opioid- and anesthetic-sparing effects exhibited in this case facilitated rapid postoperative recovery and early discharge.
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Regional Techniques for Thoracic Wall Surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Purpose of Review Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years. Recent Findings Noteworthy developments include ultrasonography for the performance of Thoracic epidural and paravertebral blockade, evidence indicating that Thoracic paravertebral blockade carries similar analgesic efficacy to Thoracic epidural analgesia, but with a superior side effect profile, and the description of multiple novel fascial plane techniques, including paraspinal Thoracic plane blocks, intercostal-paraspinal plane blocks, the pectoral blocks, and the serratus plane block. Summary Ultrasound continues to change the practice of regional anesthesia, with integration into time-honored techniques such as epidural or paravertebral blockade. The established gold standard—the Thoracic epidural—is being challenged, with a move towards paravertebral blockade. Fascial plane blocks hold promise for the future, but require further clinical trials for validation.
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Regional Techniques for Thoracic Wall Surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Purpose of Review Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years.
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regional techniques for Thoracic Wall surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years. Noteworthy developments include ultrasonography for the performance of Thoracic epidural and paravertebral blockade, evidence indicating that Thoracic paravertebral blockade carries similar analgesic efficacy to Thoracic epidural analgesia, but with a superior side effect profile, and the description of multiple novel fascial plane techniques, including paraspinal Thoracic plane blocks, intercostal-paraspinal plane blocks, the pectoral blocks, and the serratus plane block. Ultrasound continues to change the practice of regional anesthesia, with integration into time-honored techniques such as epidural or paravertebral blockade. The established gold standard—the Thoracic epidural—is being challenged, with a move towards paravertebral blockade. Fascial plane blocks hold promise for the future, but require further clinical trials for validation.
Kim Wild - One of the best experts on this subject based on the ideXlab platform.
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Regional Techniques for Thoracic Wall Surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Purpose of Review Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years. Recent Findings Noteworthy developments include ultrasonography for the performance of Thoracic epidural and paravertebral blockade, evidence indicating that Thoracic paravertebral blockade carries similar analgesic efficacy to Thoracic epidural analgesia, but with a superior side effect profile, and the description of multiple novel fascial plane techniques, including paraspinal Thoracic plane blocks, intercostal-paraspinal plane blocks, the pectoral blocks, and the serratus plane block. Summary Ultrasound continues to change the practice of regional anesthesia, with integration into time-honored techniques such as epidural or paravertebral blockade. The established gold standard—the Thoracic epidural—is being challenged, with a move towards paravertebral blockade. Fascial plane blocks hold promise for the future, but require further clinical trials for validation.
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Regional Techniques for Thoracic Wall Surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Purpose of Review Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years.
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regional techniques for Thoracic Wall surgery
Current Anesthesiology Reports, 2017Co-Authors: Kim Wild, Ki Jinn ChinAbstract:Regional anesthesia of the Thoracic Wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years. Noteworthy developments include ultrasonography for the performance of Thoracic epidural and paravertebral blockade, evidence indicating that Thoracic paravertebral blockade carries similar analgesic efficacy to Thoracic epidural analgesia, but with a superior side effect profile, and the description of multiple novel fascial plane techniques, including paraspinal Thoracic plane blocks, intercostal-paraspinal plane blocks, the pectoral blocks, and the serratus plane block. Ultrasound continues to change the practice of regional anesthesia, with integration into time-honored techniques such as epidural or paravertebral blockade. The established gold standard—the Thoracic epidural—is being challenged, with a move towards paravertebral blockade. Fascial plane blocks hold promise for the future, but require further clinical trials for validation.
Ole Goertz - One of the best experts on this subject based on the ideXlab platform.
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Thoracic Wall reconstruction after tumor resection
Frontiers in oncology, 2015Co-Authors: Kamran Harati, Jonas Kolbenschlag, Björn Behr, Ole Goertz, Tobias Hirsch, Nicolai Kapalschinski, Andrej Ring, Marcus Lehnhardt, Adrien DaigelerAbstract:Introduction: Surgical treatment of malignant Thoracic Wall tumors represents a formidable challenge. In particular, locally advanced tumors that have already infiltrated critical anatomic structures are associated with a high surgical morbidity and can result in full thickness defects of the Thoracic Wall. Plastic surgery can reduce this surgical morbidity by reconstructing the Thoracic Wall through various tissue transfer techniques. Sufficient soft tissue reconstruction of the Thoracic Wall improves life quality and mitigates functional impairment after extensive resection. The aim of this article is to illustrate the various plastic surgery treatment options in the multimodal therapy of patients with malignant Thoracic Wall tumors. Material und methods: This article is based on a review of the current literature and the evaluation of a patient database. Results: Several plastic surgical treatment options can be implemented in the curative and palliative therapy of patients with malignant solid tumors of the chest Wall. Large soft tissue defects after tumor resection can be covered by local, pedicled or free flaps. In cases of large full-thickness defects, flaps can be combined with polypropylene mesh to improve chest Wall stability and to maintain pulmonary function. The success of modern medicine has resulted in an increasing number of patients with prolonged survival suffering from locally advanced tumors that can be painful, malodorous or prone to bleeding. Resection of these tumors followed by Thoracic Wall reconstruction with viable tissue can substantially enhance the life quality of these patients. Discussion: In curative treatment regimens, chest Wall reconstruction enables complete resection of locally advanced tumors and subsequent adjuvant radiotherapy. In palliative disease treatment, stadium plastic surgical techniques of Thoracic Wall reconstruction provide palliation of tumor-associated morbidity and can therefore improve patient quality of life.
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Thoracic Wall Reconstruction in Advanced Breast Tumours.
Geburtshilfe und Frauenheilkunde, 2014Co-Authors: Adrien Daigeler, Kamran Harati, Björn Behr, Ole Goertz, Tobias Hirsch, Marcus Lehnhardt, Jonas KolbenschlagAbstract:In advanced mammary tumours, extensive resections, sometimes involving sections of the Thoracic Wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large Thoracic Wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of Thoracic Wall resection on the respiratory mechanism can be easily compensated for and patientsʼ quality of life in the palliative stage of disease can often be improved.
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reconstruction of the Thoracic Wall long term follow up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare.
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Reconstruction of the Thoracic Wall—long-term follow-up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare. Materials and methods The data of 92 consecutive patients with full thickness chest Wall resections were acquired from patient’s charts and contact to patients, their relatives or general practitioners, with special reference to treatment and clinical course. At a mean follow-up of 5.5 years, 36 patients were examined physically and interviewed. Twenty-seven of them underwent additional pulmonary function tests. Kaplan–Meier method was used to calculate survival. Regression tests were undertaken to identify factors influencing the outcome. Results Postoperative complications were observed in 42.4%, but neither mesh implantation nor the size of the defect contributed significantly. The 5-year mortality was worse for patients with recurrent mamma carcinoma (90.6%) than for patients with soft tissue sarcoma (56.3%). No medical history or operation parameter (resection size and localization) besides the general patients’ conditions increased mortality. Pulmonary function parameters were only moderately reduced and not significantly affected by the resections’ size or its localization. Majority of patients suffer from sensation disorders and motion-dependent pain, which contributed significantly to hypoxemia. Quality-of-life parameters were significantly reduced compared to the healthy control group but similar to the control group with cancer according to the Short Form-36 protocol. We could not detect a relevant decrease in quality of life comparing post- to preoperative values. Conclusions Thoracic Wall reconstruction provides sufficient Thoracic Wall stability to maintain pulmonary function, but postoperative pain and sensation disorders are considerable. However, chest Wall repair can contribute to palliation and even cure after full-thickness resections.
Marcus Lehnhardt - One of the best experts on this subject based on the ideXlab platform.
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Thoracic Wall reconstruction after tumor resection
Frontiers in oncology, 2015Co-Authors: Kamran Harati, Jonas Kolbenschlag, Björn Behr, Ole Goertz, Tobias Hirsch, Nicolai Kapalschinski, Andrej Ring, Marcus Lehnhardt, Adrien DaigelerAbstract:Introduction: Surgical treatment of malignant Thoracic Wall tumors represents a formidable challenge. In particular, locally advanced tumors that have already infiltrated critical anatomic structures are associated with a high surgical morbidity and can result in full thickness defects of the Thoracic Wall. Plastic surgery can reduce this surgical morbidity by reconstructing the Thoracic Wall through various tissue transfer techniques. Sufficient soft tissue reconstruction of the Thoracic Wall improves life quality and mitigates functional impairment after extensive resection. The aim of this article is to illustrate the various plastic surgery treatment options in the multimodal therapy of patients with malignant Thoracic Wall tumors. Material und methods: This article is based on a review of the current literature and the evaluation of a patient database. Results: Several plastic surgical treatment options can be implemented in the curative and palliative therapy of patients with malignant solid tumors of the chest Wall. Large soft tissue defects after tumor resection can be covered by local, pedicled or free flaps. In cases of large full-thickness defects, flaps can be combined with polypropylene mesh to improve chest Wall stability and to maintain pulmonary function. The success of modern medicine has resulted in an increasing number of patients with prolonged survival suffering from locally advanced tumors that can be painful, malodorous or prone to bleeding. Resection of these tumors followed by Thoracic Wall reconstruction with viable tissue can substantially enhance the life quality of these patients. Discussion: In curative treatment regimens, chest Wall reconstruction enables complete resection of locally advanced tumors and subsequent adjuvant radiotherapy. In palliative disease treatment, stadium plastic surgical techniques of Thoracic Wall reconstruction provide palliation of tumor-associated morbidity and can therefore improve patient quality of life.
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Thoracic Wall Reconstruction in Advanced Breast Tumours.
Geburtshilfe und Frauenheilkunde, 2014Co-Authors: Adrien Daigeler, Kamran Harati, Björn Behr, Ole Goertz, Tobias Hirsch, Marcus Lehnhardt, Jonas KolbenschlagAbstract:In advanced mammary tumours, extensive resections, sometimes involving sections of the Thoracic Wall, are often necessary. Plastic surgery reconstruction procedures offer sufficient opportunities to cover even large Thoracic Wall defects. Pedicled flaps from the torso but also free flap-plasties enable, through secure defect closure, the removal of large, ulcerated, painful or bleeding tumours with moderate donor site morbidity. The impact of Thoracic Wall resection on the respiratory mechanism can be easily compensated for and patientsʼ quality of life in the palliative stage of disease can often be improved.
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reconstruction of the Thoracic Wall long term follow up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare.
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Reconstruction of the Thoracic Wall—long-term follow-up including pulmonary function tests
Langenbeck's Archives of Surgery, 2009Co-Authors: Adrien Daigeler, Ole Goertz, Marcus Lehnhardt, D Druecke, Mitra Hakimi, H W Duchna, H H Homann, H U SteinauAbstract:Purpose Thoracic Wall reconstructions have become a standard procedure for the reconstructive plastic surgeon in the larger hospital setting, but detailed reports about long-term results including pulmonary function and physical examination are rare. Materials and methods The data of 92 consecutive patients with full thickness chest Wall resections were acquired from patient’s charts and contact to patients, their relatives or general practitioners, with special reference to treatment and clinical course. At a mean follow-up of 5.5 years, 36 patients were examined physically and interviewed. Twenty-seven of them underwent additional pulmonary function tests. Kaplan–Meier method was used to calculate survival. Regression tests were undertaken to identify factors influencing the outcome. Results Postoperative complications were observed in 42.4%, but neither mesh implantation nor the size of the defect contributed significantly. The 5-year mortality was worse for patients with recurrent mamma carcinoma (90.6%) than for patients with soft tissue sarcoma (56.3%). No medical history or operation parameter (resection size and localization) besides the general patients’ conditions increased mortality. Pulmonary function parameters were only moderately reduced and not significantly affected by the resections’ size or its localization. Majority of patients suffer from sensation disorders and motion-dependent pain, which contributed significantly to hypoxemia. Quality-of-life parameters were significantly reduced compared to the healthy control group but similar to the control group with cancer according to the Short Form-36 protocol. We could not detect a relevant decrease in quality of life comparing post- to preoperative values. Conclusions Thoracic Wall reconstruction provides sufficient Thoracic Wall stability to maintain pulmonary function, but postoperative pain and sensation disorders are considerable. However, chest Wall repair can contribute to palliation and even cure after full-thickness resections.
