Multidisciplinary Oncoplastic Approach Reduces Infection in Chest Wall Resection and Reconstruction for Malignant Chest Wall Tumors

Abstract

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Impact of Surgically and Radiologically Detected Incidental Internal Mammary Lymph Node Enlargement in Breast Cancer Patients Undergoing Free-Flap Breast Reconstruction

“…Observation from previously published reports demonstrated that proximate collaboration between several disciplines with a multidisciplinary thoracic oncoplastic approach is of paramount importance in devising a comprehensive and safe outcome for this challenging group of patients. 34,35 Few studies reported a strong relationship between tumor location and the lymphatic drainage, with medial tumors lymphatic drainage been higher to IMLN 1,34 ; however, it was not emphasized by other studies. 9,32 This has led to an ongoing debatable issue that patients with medially located tumors are understaged and receive inadequate oncological treat-ment.…”

Contributing factors to the outcome of primary malignant chest wall tumors

“…In our study, chest wall reconstruction was done by the use of double layer Prolene mesh with or without bone cement that is covered either by rotational pedicle muscle flap (LD or serratus anterior) , that were chosen by proximity, knowing the arc of rotation and calculating the area of possible coverage, or covered by the local muscle flap (pectoralis major). In most cases, only a single muscle was transferred (27,29). CWT resection is associated with a low major morbidity as long as reconstruction was done when indicated (1,8).…”

“…Bony reconstruction should be tailored to the extent of resection. Stabilization of the chest wall obviates the need for prolonged ventilation as patients are able to maintain their pulmonary function postoperatively (6,27). Muscle and musculocutaneous flaps are the tissues of choice to cover the wound, avoid or decrease the risk of infection, obliterate spaces and cover the synthetic mesh (28).…”

Chest Wall Mechanics In Vivo With a New Custom-Made Three-Dimensional–Printed Sternal Prosthesis

“…The same surgical team performed the first and second procedures, and the patient was cared for on the same postoperative ward [6]. The patient again made an excellent recovery.…”