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Radical resection of sternum
CPT4 code
Name of the Procedure:
Radical Resection of Sternum
- Common Name: Complete Sternum Removal
- Medical Term: Radical Sternal Resection
Summary
Radical resection of the sternum is a surgical procedure to remove the entire sternum (breastbone) to treat cancer, infection, or severe trauma. This major surgery often requires replacing the sternum with synthetic materials or using tissue from other parts of the body to reconstruct the chest wall.
Purpose
Medical Condition:
- Treatment for cancer (e.g., sarcoma, metastatic tumors)
- Severe infections not responsive to antibiotics
- Traumatic injuries causing significant damage to the sternum
Goals:
- Complete removal of diseased or damaged tissue
- Prevent the spread of cancer
- Maintain structural integrity and function of the chest wall
Indications
Symptoms and Conditions:
- Pain and swelling in the chest
- Difficulty breathing due to sternal deformities or tumors
- Visible or diagnostic evidence of sternum tumors or severe infections
Patient Criteria:
- Patients diagnosed with sternal malignancy or severe infection
- Cases where less invasive treatments are ineffective or inappropriate
Preparation
Pre-Procedure Instructions:
- Fasting for at least 8 hours before surgery
- Adjusting medications as advised by the physician
- Stopping blood thinners or anticoagulants
Diagnostic Tests:
- Imaging studies (CT scans, MRIs)
- Blood tests to check overall health status
- Pulmonary function tests to assess lung capacity
Procedure Description
Steps:
- Administration of general anesthesia
- Making an incision over the sternum to access the chest cavity
- Carefully removing the sternum along with affected tissues
- Reconstructing the chest wall using synthetic materials or autologous tissue grafts
- Ensuring proper placement and attachment of reconstructed structures
- Closing the incision with sutures or staples
Tools and Technology:
- Surgical scalpels and saws
- Synthetic meshes and plates
- Autologous tissue grafting techniques
Anesthesia:
- General anesthesia is administered to ensure the patient is unconscious and pain-free
Duration
- The procedure typically takes about 4 to 6 hours, depending on the complexity of the case.
Setting
- Performed in a hospital operating room
Personnel
- Cardiothoracic surgeons
- Anesthesiologists
- Surgical nurses
- Operating room technicians
Risks and Complications
Common Risks:
- Infection at the surgical site
- Bleeding
- Pain and discomfort
Rare Risks:
- Implant rejection or failure
- Respiratory complications
- Complications from anesthesia
Management:
- Antibiotics to prevent or treat infection
- Blood transfusions if significant bleeding occurs
- Postoperative pain management
Benefits
- Complete removal of diseased tissue
- Prevention of disease progression
- Enhanced quality of life through restored chest wall function
Recovery
Post-Procedure Care:
- Pain management with medications
- Monitoring in the hospital for several days
- Breathing exercises and physical therapy
Expected Recovery Time:
- Initial recovery in 4 to 6 weeks
- Full recovery can take several months, with activity restrictions
Follow-Up:
- Regular check-ups to monitor healing and function
- Imaging studies to ensure no recurrence
Alternatives
Other Treatment Options:
- Chemotherapy or radiation for cancer
- Less invasive surgeries for minor infections or trauma
- Conservative management with medication
Pros and Cons:
- Alternatives may be less invasive but less effective for severe conditions
- Radical resection offers definitive treatment with higher success rates for certain conditions
Patient Experience
During Procedure:
- The patient is under general anesthesia and will not feel anything during the surgery
After Procedure:
- Pain and swelling around the incision site
- Hospital stay to monitor recovery
- Gradual return to normal activities guided by medical advice
Pain Management:
- Effective pain relief through prescribed medications
- Measures like cold packs and gentle movement to alleviate discomfort