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Chest wall reconstruction. Experience with 100 consecutive patients.

P G Arnold, P C Pairolero

    Annals of Surgery
    |June 1, 1984
    PubMed
    Summary

    This study reviewed 100 chest wall reconstructions, finding that most patients achieved excellent outcomes after complex surgical procedures. Surgical techniques included skeletal resection and muscle flaps for diverse chest wall pathologies.

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    Area of Science:

    • Thoracic Surgery
    • Surgical Oncology
    • Reconstructive Surgery

    Background:

    • Chest wall defects present complex reconstructive challenges.
    • Causes include tumors, radiation necrosis, and post-sternotomy infections.
    • Effective reconstruction is vital for respiratory function and patient recovery.

    Purpose of the Study:

    • To review outcomes of 100 consecutive chest wall reconstructions.
    • To analyze surgical techniques and patient demographics.
    • To evaluate the efficacy of various reconstructive methods.

    Main Methods:

    • Retrospective review of 100 patients undergoing chest wall reconstruction over 7 years.
    • Analysis of patient demographics, etiologies, surgical procedures, and outcomes.

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  • Procedures included skeletal resection, muscle flaps (pectoralis major, latissimus dorsi), omental transposition, and mesh/autogenous rib reconstruction.

    • Main Results:

    • Average patient age was 53 years, with a near-even gender distribution.
    • Common indications were tumors (42), infected median sternotomies (24), and radiation necrosis (19).
    • 92% of patients received muscle flaps, and 29 utilized Prolene mesh for skeletal defects. Excellent results were observed in 99% of survivors.

    Conclusions:

    • Chest wall reconstruction using diverse surgical techniques yields excellent outcomes.
    • Complex reconstructions, including skeletal resection and muscle flaps, are effective for various pathologies.
    • Multidisciplinary surgical approaches are crucial for successful chest wall reconstruction.