Non-rigid reconstruction of chest wall defects after resection of musculoskeletal tumors

Abstract

Purpose: We analyzed the techniques used and the complications occurring in chest wall reconstruction after resection of musculoskeletal tumors to identify the optimal reconstruction method. Methods: The medical records of 50 patients with primary or metastatic malignant tumors requiring chest wall full thickness resection were retrospectively reviewed. The surgical technique and rate of postoperative complications were investigated, and the factors influencing complications were identified. Results: Flap transfer was used in 23 cases (46 %). For skeletal reconstruction, a prosthetic mesh was used in 19 cases. In 18 recent cases, no prosthetic mesh was used, and patients were treated using only suture stabilization. Postoperative complications were recognized in 11 cases (22 %). The analysis of factors influencing the development of complications identified the use of preoperative adjuvant chemotherapy (p < 0.05), the bone as the primary site (p < 0.05), an anterolateral location (p = 0.081) and resection of ≥3 ribs (p = 0.077) as significant factors. No significant difference in the rate of complications was noted between the groups divided based on whether mesh was used. Conclusion: We used non-rigid reconstruction for full thickness resection of the chest wall, and achieved good postoperative outcomes with no grade 4 complications or perioperative mortality. Non-rigid reconstruction using flap transfers and careful respiratory management is a useful method for treating patients requiring chest wall full thickness resection.