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Repair of huge thoracic defect combined with hernia after multimodality treatment of breast cancer. Respir Med Case Rep 2021; 34:101558. [PMID: 34877252 PMCID: PMC8633021 DOI: 10.1016/j.rmcr.2021.101558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
A case of the successful reconstruction of an extensive chest wall defect combined with a ventral hernia in a patient after multimodality treatment of breast cancer complicated by sternal and costal osteomyelitis is presented. To recover the chest mechanics, with emphasis on the supporting function, and to repair the hernial defect, customized reinforced “sandwich” TiNi rib endografts and knitted TiNi surgical mesh were used. A five-year follow-up indicated no recurrence of osteomyelitis or ventral hernia, and no failure/migration of the implants or instability of the thorax. Excellent clinical and functional outcomes were achieved pursuant to the Enneking score.
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Topolnitskiy E, Chekalkin T, Marchenko E, Yasenchuk Y, Kang SB, Kang JH, Obrosov A. Evaluation of Clinical Performance of TiNi-Based Implants Used in Chest Wall Repair after Resection for Malignant Tumors. J Funct Biomater 2021; 12:jfb12040060. [PMID: 34842727 PMCID: PMC8628886 DOI: 10.3390/jfb12040060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/14/2022] Open
Abstract
In this study, we assessed the outcomes after surgical treatment of thoracic post-excision defects in 15 patients, using TiNi knitted surgical meshes and customized artificial TiNi-based ribs. Methods: Eight patients were diagnosed with advanced non-small cell lung cancer (NSCLC) invading the chest wall, of which five patients were T3N0M0, two were T3N1M0, and one was T3N2M0. Squamous cell carcinoma was identified in three of these patients and adenocarcinoma in five. In two cases, chest wall resection and repair were performed for metastases of kidney cancer after radical nephrectomy. Three-dimensional CT reconstruction and X-ray scans were used to plan the surgery and customize the reinforcing TiNi-based implants. All patients received TiNi-based devices and were prospectively followed for a few years. Results: So far, there have been no lethal outcomes, and all implanted devices were consistent in follow-up examinations. Immediate complications were noted in three cases (ejection of air through the pleural drains, paroxysm of atrial fibrillation, and pleuritis), which were conservatively managed. In the long term, no complications, aftereffects, or instability of the thoracic cage were observed. Conclusion: TiNi-based devices used for extensive thoracic lesion repair in this context are promising and reliable biomaterials that demonstrate good functional, clinical, and cosmetic outcomes.
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Affiliation(s)
- Evgeniy Topolnitskiy
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- Department of Surgery, Siberian State Medical University, 634050 Tomsk, Russia
| | - Timofey Chekalkin
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- R&D Center, TiNiKo Co., Ochang 28119, Korea;
- Correspondence:
| | - Ekaterina Marchenko
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
| | - Yuri Yasenchuk
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
| | - Seung-Baik Kang
- Boramae Medical Center, Seoul National University Hospital, Seoul 07061, Korea;
| | | | - Aleksei Obrosov
- Laboratory of Medical Materials, Tomsk State University, 634045 Tomsk, Russia; (E.T.); (E.M.); (Y.Y.); (A.O.)
- Department of Physical Metallurgy and Materials Technology, Brandenburg University of Technology, 03-046 Cottbus, Germany
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Chernyshova A, Kolomiets L, Chekalkin T, Chernov V, Sinilkin I, Gunther V, Marchenko E, Baigonakova G, Kang JH. Fertility-Sparing Surgery Using Knitted TiNi Mesh Implants and Sentinel Lymph Nodes: A 10-Year Experience. J INVEST SURG 2020; 34:1110-1118. [PMID: 32281433 DOI: 10.1080/08941939.2020.1745965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: The aim of this cohort study is to improve the procedure of fertility-sparing surgery and to assess oncological and reproductive follow-up outcomes after radical trachelectomy (RT) for cervical cancer (T1a2-1bNxM0).Methods: We have suggested the method combining sentinel lymph nodes (SLNs) and cervicoisthmic cerclage using a superelastic knitted TiNi mesh (KTNM) implant to facilitate the primary biomechanical/retention function of the uterus. Sixty-eight consented patients, who underwent fertility-sparing surgery using both transabdominal and laparoscopic route from 2009 through 2019, were recruited in the study and prospectively followed for a mean of 69 months.Results: There were no intraoperative or postoperative complications. No cervical stenoses or mesh failures were noted in all cases. The 5-year overall and recurrence-free survival rates were 100% and 97%, respectively. Two patients indicated recurrence, it occurred in 3 and 36 months. There were 19 (28%) spontaneous pregnancies, 6 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively.Conclusions: This sparing-surgery technique is turned out to be feasible and efficient as allows to achieve well oncologic and fertility outcomes, mimicking the effect of the cervix. It complements existing surgical approaches and may provide further insight into how to overcome challenges even in aggravated cases or previously failed procedures.
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Affiliation(s)
- Alena Chernyshova
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Larisa Kolomiets
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,Siberian State Medical University, Tomsk, Russia
| | - Timofey Chekalkin
- Tomsk State University, Tomsk, Russia.,R&D Center, Kang and Park Medical Co, Ochang, Korea
| | - Vladimir Chernov
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Ivan Sinilkin
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | | | | | | | - Ji Hoon Kang
- R&D Center, Kang and Park Medical Co, Ochang, Korea
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Shtin V, Novikov V, Chekalkin T, Gunther V, Marchenko E, Choynzonov E, Kang SB, Chang MJ, Kang JH, Obrosov A. Repair of Orbital Post-Traumatic Wall Defects by Custom-Made TiNi Mesh Endografts. J Funct Biomater 2019; 10:jfb10030027. [PMID: 31252637 PMCID: PMC6787735 DOI: 10.3390/jfb10030027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/12/2019] [Accepted: 06/24/2019] [Indexed: 02/01/2023] Open
Abstract
Repairs of orbital post-traumatic and extensive malignant defects remain a major surgical challenge, in view of follow-up outcomes. Incorrect surgical management of injured facial structures results in cosmetic, ophthalmic, and social aftereffects. A custom-made knitted TiNi-based mesh (KTNM) endograft was employed to overcome post-surgical complications and post-resected lesions of the orbital area. Preoperative high-resolution computed tomography (CT) imaging and CAD modelling were used to design the customized KTNM in each case. Twenty-five patients underwent surgery utilizing the suggested technique, from 2014 to 2019. In all documented cases, resolution of the ophthalmic malfunction was noted in the early period. Follow-up observation evidenced no relapsed enophthalmos, hypoglobus, or diplopia as late complications. The findings emanating from our clinical observations allow us to claim that the KTNM indicated a high level of biocompatibility. It is simply modified intraoperatively to attach any desired shape/size for implantation and can also be screw-fixed, providing a good supporting ability. The KTNM precisely renders orbitozygomatic outlines and orbital floor, thus recovering the anatomical structure, and is regarded as an attractive alternative to Ti-based meshes and plates. Additionally, we report one of the studied cases, where good functional and cosmetic outcomes have been achieved.
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Affiliation(s)
- Valentin Shtin
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Valeriy Novikov
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Timofey Chekalkin
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia.
- Kang and Park Medical Co., R&D Center, Ochang 28119, Korea.
| | - Victor Gunther
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia
| | - Ekaterina Marchenko
- Research Institute of Medical Materials, Tomsk State University, Tomsk 634045, Russia
| | - Evgeniy Choynzonov
- Tomsk Cancer Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634028, Russia
| | - Seung Baik Kang
- SMG-SNU Boramae Medical Center, Seoul National University, College of Medicine, Seoul 07061, Korea
| | - Moon Jong Chang
- SMG-SNU Boramae Medical Center, Seoul National University, College of Medicine, Seoul 07061, Korea
| | - Ji Hoon Kang
- Kang and Park Medical Co., R&D Center, Ochang 28119, Korea
| | - Aleksei Obrosov
- Department of Physical Metallurgy and Materials Technology, Brandenburg University of Technology, 03044 Cottbus, Germany
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Gunther V, Radkevich A, Kang SB, Chekalkin T, Marchenko E, Gunther S, Pulikov A, Sinuk I, Kaunietis S, Podgorniy V, Chang MJ, Kang JH. Study of the knitted TiNi mesh graft in a rabbit cranioplasty model. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab0693] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Zaworonkow D, Chekan M, Kusnierz K, Lekstan A, Grajoszek A, Lekston Z, Lange D, Chekalkin T, Kang JH, Gunther V, Lampe P. Evaluation of TiNi-based wire mesh implant for abdominal wall defect management. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aaa0b0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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