Reconstruction of chest wall after resection of large tumors

ABSTRACT

Introduction:

Complex procedures and implants are required in the final stages of chest wall reconstruction after tumor excision. This process requires multidisciplinary care with participation from thoracic and plastic surgeons, a radiologist, and a physical therapist. The goal of this study was to describe the options for chest wall reconstruction after neoplasm resection at Hospital Sarah Brasilia.

Method:

A retrospective study of one-time chest wall reconstruction after tumor excision, respiratory physical therapy with noninvasive ventilation, and exercises was conducted.

Results:

Between 2007 and 2012, 10 patients underwent surgery (seven men, three women; age range: 10-31 years); eight patients had metastatic thoracic tumors (e.g., osteosarcoma, synovial sarcoma, sclerosing epithelioid fibrosarcoma, and rhabdomyosarcoma) and two had tumors originating from the chest wall (fibromatosis and chondrosarcoma). The outcomes were good after the immediate postoperative period, with extubation occurring at the end of surgery and chest tube removal between the fifth and eighth postoperative day. Three cases (30%) involved complications of atelectasis (10%), tumor recurrence (10%), or death.

Conclusion:

One-time chest wall reconstruction using polypropylene mesh, polymethylmethacrylate, and muscle flaps was possible and was associated with early recovery of pulmonary function and a low rate of immediate complications.

Keywords:
Chest wall reconstruction; Thoracic tumor; Polymethylmethacrylate