Anterior chest wall reconstruction for oncologic and non-oncologic pathology: a case series

Abstract

Background: Utmost malignant, in addition to large benign tumors or deformity/trauma of the chest wall, typically require thoracic surgery to manage the abnormal growth promptly. Chest wall resection encompasses a variety of approaches from partial to full surgical removal of soft tissue, cartilage, sternum, and ribs. The reconstruction, using prosthetic materials may be employed to rebuild the skeletal structure.Methods: From January 2017 to October 2019, four consecutive patients with anterior chest diseases underwent surgical treatment. Two young patients, one with displaced traumatic sternum fracture and the other with pectus carinatum (pigeon breast), were treated by anterior chest wall resection and reconstruction with absorbable pin and titanium plating application. Two adult women with previous breast cancer, one with radio-induced sternum osteosarcoma and the other with post-actinic wall infection were treated using titanium plating application and myocutaneous flaps.Results: In both two young patients, we had good results correcting the deformities and then fixing it by using a combination of different materials. Patients and parents describe an improved emotional comfort and self-confidence, as well as an increased physical and welfare activities from pre-to post-surgery. Postoperative course was complicated for both women with previous surgery and radiotherapy for breast cancer.Both cases had skin dehiscence and needed further surgical revision. However, long-term follow-up confirms the good cosmetic result, with a satisfactory reconstruction and normal movement. Conclusions:We reported a small case series of four patients treated for a wide spectrum of different diseases with 4 different techniques. Considering the results, an aggressive, well-planned and multidisciplinary surgical treatment can give excellent success.