Management of Chest Wall Reconstruction After Resection for Cancer

Bosc, Romain; Lepage, C.; Hamou, Cynthia; Matar, Nadia; Benjoar, Marc-David; Hivelin, Mikaël; Lantieri, Laurent

doi:10.1097/sap.0b013e3181f9b292

Cited by 28 publications

(22 citation statements)

References 25 publications

(17 reference statements)

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“…In oncological cases and cases with radionecrosis, morbidity rates have been reported as 11% and 50%, respectively. [1] In present case study, average morbidity rate of 20% is consistent with literature findings. Although prevention of local recurrence does not always increase survival rate, it is known to improve patient quality of life.…”

Section: Discussionsupporting

confidence: 81%

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Multidisciplinary Approach and Clinical Algorithm in Resection and Reconstruction for Chest Wall Tumor

Demirhan¹

2017

South Clin Ist Euras

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Objective: The aim of this study was to retrospectively review files of patients who had tumor resection and reconstructive surgery performed by thoracic and plastic surgeons due to chest wall tumor, and to create reconstruction algorithm. Methods:Records of 45 patients who underwent surgery for chest wall tumor between 2006-2014 were included in this study. Data including age, sex, tumor localization, defect size, quantity of resected costa and bone, and method of skeletal and soft tissue reconstruction were gathered retrospectively from patient files. Results:The largest defect was 325 cm 2 and smallest was 36 cm 2 . Titanium mesh was used in 54% of patients, while prolene mesh was used in 32%. Pectoralis kite flap (n=14), latissumus dorsi muscle-skin muscle flap (n=12), latissumus dorsi muscle flap and pectoral kite flap (n=5), vertical rectus abdominus skin muscle flap (n=6), omentum flap (n=3), transvers rectus abdominus skin muscle flap (n=3), free anterolateral thigh flap (n=2), and local rotation flap (n=1) were used for soft tissue reconstruction. Conclusion:Algorithm for soft and skeletal tissue reconstruction was created in accordance with obtained data.

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Section: Discussionsupporting

confidence: 81%

“…Soft tissue and bony skeleton may be affected. [1,2] There may be synthetic vascular structures at base of defect, and in addition, defects of diaphragm or anterior abdominal wall can develop. Large areas of damage, loss of skeletal support, and deep dead spaces are characteristic features of these defects.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Approach and Clinical Algorithm in Resection and Reconstruction for Chest Wall Tumor

Demirhan¹

2017

South Clin Ist Euras

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“…Extensive chest wall defects that involve soft and skeletal tissues may be the end result of chest wall resection of those tumors with 2 available method for reconstruction of such defects; prosthetic or biologic mesh and/or flaps with their blood supply (3,(5)(6)(7). Recent advances in the techniques of skeletal and musculocutaneous reconstructions have facilitated the treatment of these tumors so that tumor size is not a contraindication to radical excision (8).…”

Section: Introductionmentioning

confidence: 99%

Contributing factors to the outcome of primary malignant chest wall tumors

et al. 2017

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Background: Primary malignant chest-wall tumors (PMCWTs) are a heterogeneous group of tumors.They require a special experience in designing resection and reconstruction. They account for less than 1% of all primary malignant tumors. This study is designed to clarify different factors contributing to the outcome of patients with PMCWTs in our institution. Methods: A retrospective study included 98 patients with pathology proven PMCWTs, treated at the National Cancer Institute (NCI), Cairo University, Egypt, during the past 10 years.

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“…1 The thoracic respiration is expansion and shrinkage of the thorax that results from the contracture and relaxation of respiratory muscles. This movement is an orchestrated action of the components of the thorax -the ribs, costal cartilages, and sternum.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are situations, where the team has to play without this important member. In some clinical cases, partial or total resection of the sternum is needed to remove tumors invading the sternum, [1][2][3][4][5] or to treat osteomyelitis of the sternum. [6,7] In these situations, the thoracic respiration can be negatively affected because the connection of bilateral thoraces though the sternum is impaired.…”

Section: Introductionmentioning

confidence: 99%

A biomechanical study of relationship between sternum defect patterns and thoracic respiration

Nagasao

Kasai

Shimizu

et al. 2016

Computer Assisted Surgery

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Background: Various types of sternum defects are produced after the removal of thoracic tumors involving the sternum. The present study aims to elucidate the relationship between the defect patterns and their effects on thoracic respiration. Methods: Ten sets of finite element models were produced simulating thoraces of 10 persons and termed normal models. With each of the 10 normal models, the sternum was removed in six different ways to produce new models termed defect models. Defect models were categorized into hemi-superior (H-S), hemi-inferior (H-I), hemi-whole length (H-W), bilateral-superior (B-S), bilateralinferior (B-I), and bilateral-whole length (B-W) defect types, depending on the locations of the defects. Respiratory movement was dynamically simulated with these models. The volume change the thoraces present during respiration was measured to evaluate the effectiveness of thoracic respiration. This value -defined as DV -was calculated and was compared between normal and defect models. Results: With H-W and B-W type models, DV dropped to around 20% of normal values. With H-S and B-S type models, DV dropped to around 50% of normal values. With H-I and B-I type models, DV presented values almost equivalent to those of normal models. Conclusion: Effectiveness of thoracic respiration is seriously impaired when the whole length of the sternum is absent. Reconstruction of the defect is essential for these cases. However, since the upper part of the sternum is most important for effective thoracic respiration, priority should be placed on the upper part in performing reconstruction.

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Management of Chest Wall Reconstruction After Resection for Cancer

Cited by 28 publications

References 25 publications

Multidisciplinary Approach and Clinical Algorithm in Resection and Reconstruction for Chest Wall Tumor

Multidisciplinary Approach and Clinical Algorithm in Resection and Reconstruction for Chest Wall Tumor

Contributing factors to the outcome of primary malignant chest wall tumors

A biomechanical study of relationship between sternum defect patterns and thoracic respiration

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