Surgical treatment of chest wall tumors (resection and reconstruction) A six years experience

Abstract

Background: Chest wall resection and reconstruction remains one of the most challenging areas of Thoracic & Plastic Surgery. The purpose of this study is to report our 6-year experience with chest wall resections and reconstructions. Methods: A retrospective review of 36 patients who had chest wall resections from 1998 to 2003 was performed. Result: Patient demographics included tobacco abuse, hypertension, diabetes mellitus, niswar abuse, coronary artery disease, chronic obstructive pulmonary disease, and HCV +ve. Surgical indications included chest wall tumors, and lung cancer involving the chest wall. The mean number of ribs resected was 4±2 ribs. Thirty four patients underwent chest wall resections. Two patients underwent right upper lobectomy along with chest wall resections. Immediate closure was performed in all 36 patients. Primary repair without the use of reconstructive techniques was possible in 9 patients. Synthetic chest wall reconstruction was performed using Prolene mesh, Marlex mesh, methyl methacrylate sandwich, and polytetrafluoroethylene. Flaps utilized for soft tissue coverage were pedicled flaps (2 patients). Mean postoperative length of stay was 14±12 days. Mean intensive care unit stay was 5+4 days. In-hospital and 30-day survival was 100%. Conclusions: Chest wall resection with reconstruction can be performed as a safe, effective one-stage surgical procedure for a variety of major chest wall defects.