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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">To the Editor&#58;</span></p><p id="par0010" class="elsevierStylePara elsevierViewall">Computer-assisted surgery is an extremely useful tool for planning the resection of tumors that require anatomical accuracy to achieve tumor-free margins&#46; This technique offers the surgeon precise information on the extent of such margins during the procedure&#44; thus avoiding unnecessary resections&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We report the case of a female patient who underwent navigation-guided resection of a chest wall sarcoma that had been excised in a previous procedure&#44; with positive surgical margins&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">This was a 43-year-old woman with a history of resection of a tumor in her back&#44; without resection of thoracic wall&#46; The postoperative pathology report confirmed soft-tissue sarcoma with positive surgical margins&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The case was discussed by the multidisciplinary committee&#44; and given that the resection showed positive margins&#44; oncological surgery was planned with <span class="elsevierStyleItalic">en bloc</span> chest wall resection including soft tissues affected by the previous surgery&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In our patient&#44; we used 2 approaches that are routine in chest wall tumors&#58; virtual surgical planning and navigation&#44; performed on virtual simulation platforms that can be used to merge digital images &#40;MRI pre&#44; MRI post&#44; 2D tomographies&#44; 3D tomographies&#41;&#46; Once the virtual surgical planning had been completed&#44; navigation-guided surgery can be used to achieve tumor-free margins with an accuracy of millimeters&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">As the tumor had been resected in a previous procedure&#44; we had to decide the anatomical limits for oncological resection with tumor-free margins&#46; We decided to use virtual surgical planning based on a magnetic resonance image obtained prior to the initial surgery&#44; which showed the soft-tissue lesion in contact with the 8th&#44; 9th&#44; and 10th ribs &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; The lesion was reconstructed virtually in a new CT scan performed on the same day of surgery &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Using the intraoperative navigation system&#44; oncological resection of the chest wall <span class="elsevierStyleItalic">en bloc</span> with soft tissues was performed&#44; and 3 rib sections were resected &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C and D&#41; and reconstructed with osteosynthesis material&#46; The postoperative period was incident-free&#44; and the patient was discharged on day 6 post-procedure&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Primary tumors of the chest wall are rare cancers that represent less than 5&#37; of all thoracic tumors&#46; The 3 most common subtypes are chondrosarcomas&#44; liposarcomas&#44; and fibrosarcomas&#46; Surgical resection with adequate tumor-free margins is critical to achieve the best oncological outcome&#46; Surgeons should have a broad knowledge of the principles and different methods of chest wall resection and reconstruction&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The importance of computer-assisted surgery in providing support for both preoperative and intraoperative planning&#44; especially in patients with oncological disease&#44; has already been established in the literature&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In chest wall tumors&#44; intraoperative navigation is used to orient the surgeon in the 3-dimensional space and guide the surgery by matching the images acquired and processed before surgery with real anatomical landmarks&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">We report a situation which&#44; to our knowledge&#44; has not been previously described in the literature&#46; Magnetic resonance images obtained before the initial surgery were merged with images of a subsequent computed tomography in which the lesion was no longer present &#40;per surgical history&#41;&#46; Virtual reconstruction of the resected lesion allowed us to perform oncological surgery obtaining tumor-free margins in a previously operated patient&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Lopez SBO&#44; Ritacco LE&#44; Dietrich A&#44; Montagne JA&#44; Smith DE&#46; Resecci&#243;n de pared tor&#225;cica guiada por navegaci&#243;n en paciente con antecedente de resecci&#243;n de sarcoma con m&#225;rgenes oncol&#243;gicos comprometidos&#46; Arch Bronconeumol&#46; 2020&#59;56&#58;178&#8211;179&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Magnetic resonance imaging &#40;MRI&#41; of the patient&#8217;s chest before the initial surgery&#46; B&#41; Tomographic reconstruction of the original injury generated from the MRI&#46; C&#41; Intraoperative navigation&#46; D&#41; resection&#46;</p>"
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