Chest wall resection and reconstruction : analysis of 11 cases after methylmethacrylate reconstruction

Abstract EN

Background : Patients with extensive resection of the chest wall, followed by reconstruction with methyl-methacrylate and double prolene mesh in the form of "sandwich" prosthesis.

Substitutes were assessed prospec¬tively as chest wall defects continue to present a compli¬cated treatment scenario for thoracic and reconstructive surgeons.

Objectives : To evaluate the results of eleven patients who underwent chest wall resection and reconstruction.

Materials and Methods : Eleven patients were pro-spectively reviewed who underwent chest wall resection and reconstruction at National Cancer Institute Cairo University.

Among them, 7 were male and 4 female.

The mean age was 34.5 (SDV + 19.8) years.

The indications for resection were primary chest wall tumor in 7 patients (63.7 %), recurrence of breast cancer 2 (18.2 %), lung cancer with invasion of chest wall 1 (9.1 %) and pleuro-blastoma I (9.1 %).

Results : The mean number of rib resected was 4.18 + 1.16 ribs (3-6).

Concomitant resection was done in 6 patients ; including lung resection 2, partial resection of diaphragm 2, lateral clavicle with forequarter amputation 1 and partial stcmectomy 1.

All patients underwent skeletal reconstruction (SR) with methylmethacrylate and double prolene mesh in the form of'sandwich" prosthesis.

Simul¬taneous SR and soft tissue reconstruction (STR) were performed in 7 patients 63.7 %.

Five patients (45.5 %) developed postoperative complications with no perioper¬ative mortality.

Follow-up was carried out for a mean period of 18.7 months (11-36).

Three patients developed relapse (27.3 %), local recurrence in two cases and bone metastases in one case.

Conclusions : Chest wall resection followed immedi-ately by reconstruction utilizing synthetic mesh with a filler of methylmethacrylate with or without local or pedicled muscle flaps can be performed as a safe, effective one-stage surgical procedure for major chest wall defects which prevents paradoxical movement of chest wall and overcomes deformity.