[Indication and method of chest wall reconstruction]

Fifty two patients with chest wall resection were reviewed, with emphasis upon 16 patient with chest wall reconstruction. The latter 16 patient consisted of 6 with metastatic tumor, 3 of primary lung cancer, 2 of breast cancer, one of primary chest wall tumor, and others. Before 1985, reconstruction after chest wall resection was conducted in four cases by using methyl methacrylate (Resin). One patient developed erosion of the overlying skin due to protrusion of the edge of Resin-plate with delayed wound healing. Since 1986, we have employed muscle or myocutaneous flap and/or Marlex mesh in reconstruction of the chest wall defect. Twelve patients underwent surgery in this way. Neither paradoxical movement of the chest wall nor respiratory distress developed in the postoperative course of any patient. Thirty six of fifty two patients underwent chest wall resection without following reconstruction as in the former group. Of them one patient of anterior chest wall resection developed respiratory failure. We conclude that rib resection involving as many as three or more in the anterior chest wall, or four rib resection or more in the lateral chest wall, if the area of the defect is greater than 100 cm2, chest wall reconstruction is indicated. Moreover, we believe that muscle or myocutaneous flap and/or Marlex mesh in the best way of reconstruct in following chest wall resection.