Maintaining lung volume in a chest wall deformity after chest wall reconstruction

Malignant chest wall tumor is a generic term for a variety of tumors arising from bone and cartilage of the chest wall. Treatment of malignant chest wall tumors includes resection and chest wall reconstruction. This study aimed to evaluate whether lung volume is maintained in the presence of postoperative chest wall deformity.

Forty-seven patients with malignant chest wall tumors who were treated with full thick resection at our hospital were enrolled in the current study. The prognosis associated with pathologic diagnosis and the surgical method were examined. Among the patients in whom ribs were resected, chest wall chest deformities and postoperative lung volume changes were analyzed by reconstructive computed tomography (CT). Chest wall deformities were assessed based on anteroposterior (AP) and transverse asymmetry at the level of the fourth rib.

Chondrosarcoma was the most common tumor in 14 patients (30%). The overall 5-year survival was 51%. Among the 30 patients who underwent rib resection, the AP asymmetry ratio was increased, especially in the group with ≥4 rib resections, but the difference between patients who did and did not undergo rib resection was not statistically different. The transverse asymmetry ratio was significantly larger postoperatively than preoperatively. Comparison of anterior, lateral, and posterior locations showed that the anterior location tended to be less deformed than others, although not significantly different. The lung volume did not change postoperatively.

Chest wall deformities occurred after chest wall reconstruction, especially with respect to the transverse asymmetry ratio; however, the lung volume was compensated and maintained.