Neo-Rib Technique of Chest Wall Reconstruction Following Oncological Resection: An Institutional Experience

Wide local en-bloc excision with negative margins is crucial in managing chest wall tumors; however, concerns regarding reconstruction feasibility, implant availability, and cost may limit the extent of resection. This study evaluates a simple, cost-effective neo-rib reconstruction technique using monofilament stainless-steel wire that enables complete oncologic resection while maintaining chest wall stability. This retrospective study evaluated 56 patients who underwent monofilament stainless steel wire neo-rib reconstruction following chest wall tumor resection at a tertiary oncology center in India (April 2016-February 2025). Demographic data, clinical characteristics, perioperative findings, and recurrence patterns were analyzed. Among the 56 patients (34 males, median age 50.4 years), 51.8% had primary tumors, with 75.9% of these arising from bone or cartilage, most commonly chondrosarcoma. Secondary tumors originated mainly from the lung (37.03%) and breast (14.8%). Neoadjuvant therapy was given to 19.6% of patients, and R0 resection was achieved in 91.1%, with 8 cases of local recurrence. Skeletal-only, skeletal plus soft tissue, and extended resections were performed in 67.8%, 32.14%, and 57.14% of patients, respectively. Rib resection was done in 92.85% (median 2.7 ribs), and 32.14% underwent soft tissue reconstruction. Adjuvant therapy was given to 37.5%. Morbidity and mortality were 37.5% and 1.78%, respectively. The stainless-steel wire neo-rib technique provides a safe, reproducible, and affordable solution for chest wall reconstruction in resource-limited settings, enabling optimal oncologic clearance while preserving respiratory function and thoracic contour.