Chest wall reconstruction after resection in lung cancer: personal experience

Chest wall reconstruction after resection, for locally advanced lung cancer but also for some selected secondary tumors, is a demanding challenge to surgeons, anesthetists and experts in respiratory function rehabilitation who must guarantee a regular natural ventilation, adequate protection of intrathoracic organs and acceptable cosmetic outcome. To this aim, many procedures using autologous, heterologous, or prosthetic materials, are available. A study conducted on 13 lung cancer patients who after resection underwent reconstruction with heterologous prosthetic material is presented. No intraoperative mortality or septic complications were observed. There was prompt wall stabilization in 10 patients; it occurred 3 weeks later in another patient (polytetrafluoridethylene patch). Only in one patient (prolene mesh) a seroma developed, treated with US-guided drainage. In the authors' experience, even for fairly small defects reconstruction with prosthetic material is suitable, to prevent, in case of the presence of risk factors, pulmonary hernia-induced major respiratory symptoms. Prosthetic materials are also preferred for benign lesions characterized by a long-term survival.