Chest wall and diaphragm reconstruction; a technique not well established in literature – case report

Introduction Regardless of its rarity, and indolent clinical course, chest wall tumor places high morbidity and burden on patients especially when invasion to a neighboring structure is found. Once detected, surgery is the cornerstone for treatment of such etiology combined with chemo-radiotherapy. In order to maintain intact respiratory function, chest wall reconstruction must be performed whenever resection is done. Herein, we present a case of chest wall tumor that necessitated three ribs and part of hemidiaphragm resection and reconstruction with optimal post-operative results. Case presentation A 27-year-old male patient who had chest wall and diaphragm reconstruction for a chest wall Ewing sarcoma, using a single patch of expanded polytetrafluoroethylene (ePTFE) mesh with diaphragm implanted into the middle of the mesh. There were no immediate nor post-operative complications. The patient received post-operative radiotherapy with good functional and cosmetic results. Conclusion We present a novel and safe technique for combined chest wall and diaphragmatic resection following excision of an invading tumor while ensuring cosmesis and functionality of the ribcage as well as the diaphragm.

Safety Assessment on Retaining and Protecting of Deep Foundation Excavation Adjacent to the Existing Railway

Mizhuo highway overpass crosses Jingha railway. Deep foundation excavation can cause the neighboring structure safety factor drops. To ensure the stability of the Jingha railway embankment, retaining and protecting of deep foundation excavation was set up around the foundation pit. The incremental calculation method was used to analyze the stress deformation of retaining pile and surface settlement near the deep foundation pit. The overall stability checking and anti-overturning stability checking of deep foundation excavation meet the specification requirements. The maximum horizontal displacement of retaining pile is 6.0 mm and 6.6 mm respectively. Surface settlement can not impact the existing railway embankment. In construction practice the retaining pile can be able to effectively ensure the safety of the neighboring structure and to reduce the probability of accidents.