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Complex anterior chest wall reconstruction after extensive oncologic resections: a narrative review
Andrei I Gritsiuta1, Alexander Bracken1, Abbas E Abbas2
1Department of Surgical Services, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Shanghai Chest
|May 2, 2022
Summary
This study presents four rare anterior chest wall tumor cases, highlighting complex surgical reconstruction techniques for sternal defects. Effective reconstruction is crucial for patient survival and chest wall integrity after tumor resection.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Oncoplastic reconstruction
Background:
- Anterior chest wall neoplasms are frequently malignant, with chondrosarcoma and osteosarcoma being common primary sternal tumors.
- While surgical resection guidelines exist, reconstructive techniques for large resulting defects are less frequently detailed.
Purpose of the Study:
- To present four cases of rare malignant primary anterior chest wall neoplasms.
- To illustrate diverse surgical reconstruction approaches for complex sternal defects following tumor resection.
Main Methods:
- Retrospective review of four adult patients undergoing sternal resection for primary chest wall tumors (October 2016 - March 2021).
- Techniques included radical en-bloc resection, skeletal reconstruction (hardware, allograft), and defect coverage (regional flaps, free tissue transfer, mesh).
Main Results:
- Successful outcomes were achieved in all four cases through tailored reconstruction strategies.
- Demonstrated the feasibility of various reconstruction methods for large anterior chest wall defects.
Conclusions:
- Primary sternal tumors are rare but often malignant, necessitating radical resection.
- Reconstruction of wide chest wall defects is challenging but vital for maintaining chest wall rigidity and protecting organs.
- This report delineates successful techniques and materials for complex chest wall reconstruction.
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