Chest wall resection and reconstruction for tumors: analysis of oncological and functional outcome

Scarnecchia, Elisa; Liparulo, Valeria; Capozzi, Rosanna; Ceccarelli, Silvia; Puma, Francesco; Vannucci, Jacopo

doi:10.21037/jtd.2018.05.191

Cited by 40 publications

(42 citation statements)

References 19 publications

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“…Thoracic cage reconstruction maintains anatomical and structural stability, protects vital organs, and helps sustain the respiratory mechanism. The procedure is required in 40–60% of individuals who have undergone thoracotomy (1,9,11). Reconstruction is required for individuals with ≥3 resected ribs and defects that are ≥5 cm in diameter or even for patients with smaller defects and cases of suspected thoracic cage instability (9–11,13,19).…”

Section: Discussionmentioning

confidence: 99%

“…The procedure is required in 40–60% of individuals who have undergone thoracotomy (1,9,11). Reconstruction is required for individuals with ≥3 resected ribs and defects that are ≥5 cm in diameter or even for patients with smaller defects and cases of suspected thoracic cage instability (9–11,13,19). Furthermore, because anterior and anterolateral movements are greater than posterior movements, thoracic cage reconstruction is often required (19).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, in patients with musculoskeletal tumors, the tumor is excised along with surrounding bone and soft tissue, such as muscle and skin, which causes skin and soft tissue defects. To date, there are few studies that have compared patients with lung tumors and those with musculoskeletal tumors (9,15). Furthermore, there is a limited number of studies on the changes in pulmonary function before and after combined thoracic wall resection (16).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, there is a limited number of studies on the changes in pulmonary function before and after combined thoracic wall resection (16). There is no evidence regarding the effects of reconstruction, non-reconstruction, and type of reconstruction on the functional outcomes after the procedure (9). Therefore, the present study aimed to retrospectively examine patients who required thoracic wall resection at the time of surgery for malignant tumors.…”

Section: Introductionmentioning

confidence: 99%

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Surgical complication and postoperative pulmonary function in patients undergoing tumor surgery with thoracic wall resection

et al. 2019

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Postoperative complications of thoracic wall resection include respiratory complications, skin necrosis and infection. The aim of the present study was to examine postoperative complications in patients who required combined thoracic wall resection during the surgical removal of a tumor. The present study included 68 patients; there were 50 patients with lung tumors and 18 patients with musculoskeletal tumors. The clinical factors associated with complications were compared between the two groups. Preoperative and postoperative pulmonary function tests were performed to examine the residual pulmonary function in 16 patients. Thoracic cage reconstruction was performed in 46 patients. Postoperative complications occurred in 30 (44.1%) patients, and one patient died from postoperative pneumonitis. Compared with the pulmonary function preoperative test results, the postoperative results revealed a decrease in the mean vital capacity percentage and an increase in the mean forced expiratory volume within 1 sec as a percent of the forced vital capacity. In patients with lung tumors, pneumonectomy can result in an increased rate of complications following thoracic wall resection. Residual pulmonary function is affected by impaired thoracic cage expansion and removal of the lung. However, the results of the present study demonstrated that these complications can be somewhat stabilized by thoracic wall reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical complication and postoperative pulmonary function in patients undergoing tumor surgery with thoracic wall resection

et al. 2019

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“…With a large defect such as in the present case, a muscle flap is preferable for the reconstruction. Given that the large bony defect exceeded three ribs, a stable structural support was needed with either autologous rib or synthetic material such as a mesh product (eg, polytetrafluoroethylene, acellular dermal matrix) 5 10 14–16…”

Section: Discussionmentioning

confidence: 99%

Combined bipedicled latissimus dorsi and groin flap for anterior chest wall reconstruction

Boonipat

Manrique³

et al. 2019

BMJ Case Rep

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We provide a case report of reconstruction of a massive chest wall defect after recurrent phyllodes tumour resections. The reconstruction used a bipedicled groin and latissimus dorsi flap, with composite rib autologous reconstruction. The patient successfully recovered from the operation. Our case illustrates the applicability of this flap in the armamentarium of anterior chest wall reconstructive options.

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The oncologic efficacy of extended thoracic resections

Kader

Watkins

Servais

2023

Journal of Surgical Oncology

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Locally invasive lung cancers pose unique challenges for management. Surgical resection of these tumors can pose high morbidity due to the invasion into surrounding structures, including the spine, chest wall, and great vessels. With advances in immunotherapy and chemoradiation, the role for radical resection of these malignancies and associated oncologic outcomes is evolving. This article reviews the current literature of extended thoracic resections with a focus on technical approach, functional outcomes, and oncologic efficacy.

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Chest wall resection and reconstruction for tumors: analysis of oncological and functional outcome

Abstract: free surgical margins are the main oncological prognostic factor in these patients. In patients who underwent resection of two or more ribs in a critical area, reconstruction of the bony thorax can significantly reduce the post-operative respiratory complication rate.

Cited by 40 publications

References 19 publications

Surgical complication and postoperative pulmonary function in patients undergoing tumor surgery with thoracic wall resection

Surgical complication and postoperative pulmonary function in patients undergoing tumor surgery with thoracic wall resection

Combined bipedicled latissimus dorsi and groin flap for anterior chest wall reconstruction

The oncologic efficacy of extended thoracic resections

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