Analysis of the Chest Wall Reconstruction Methods after Malignant Tumor Resection

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Chest wall defects arise from diverse causes, necessitating reconstruction after malignant tumor resection.
• Reconstruction aims to cover vital tissues, restore pulmonary function, and prevent paradoxical motion.

Purpose of the Study:

• To analyze and evaluate the outcomes and complications of chest wall reconstructions following malignant tumor resection.
• To propose a reconstruction algorithm for chest wall defects.

Main Methods:

• Retrospective review of 13 patients undergoing chest wall reconstruction for malignant tumors (2013-2022).
• Data collected included demographics, tumor type, surgical procedures, reconstruction methods (skeletal and soft tissue flaps), and complications.

Main Results:

• Seven males and six females; 12 primary tumors and 1 metastatic carcinoma.
• Pathologies included sarcoma, invasive breast carcinoma, and squamous cell carcinoma.
• Six patients had skeletal reconstruction; various myocutaneous flaps were used (latissimus dorsi, pectoralis major, rectus abdominis). One case of staged reconstruction, no flail chest post-reconstruction. Atelectasis was the most common complication.

Conclusions:

• Skeletal reconstruction is essential for defects involving multiple ribs and the sternum to prevent paradoxical chest wall motion.
• Soft tissue reconstruction choice depends on defect size and location.
• A recommended algorithm for chest wall defect reconstruction post-malignancy resection is proposed based on this experience.