Plastic surgery for an extensive chest defect, by restoring the costal arch with superelastic 3D frame modules after multivisceral resection for recurrent sarcoma

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Abstract
To restore extensive postresection chest defects remains an unsolved problem for surgeons over the world. To date, there are no regulatory oncological and surgical protocols that could be guided in choosing an implant and a procedure for its use to replace a chest defect. This communication describes a clinical case of successfully performed plastic replacement of an extensive postresection chest defect, through restoration of the costal arch with superelastic 3D titanium nickelide modules and through diaphragmopexia after a series of combined interventions, as a result of which the investigators resected 5 ribs, the left lower lobe, the diaphragmatic costal part, and the colonic splenic angle, the spleen was removed in the treatment of a multiple locally recurrent sarcoma. The stability of the position of the reinforcing artificial frame elements and their involvement in the breathing act could fully restore the respiratory biomechanics and create conditions for early activation of the female patient. The oncological and functional results show the effectiveness of the proposed technology, which expands the possibilities of treating patients with chest tumors, even in cases of simultaneous non-standard resections of the adjacent anatomical structures.

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