Problems in Chest Wall Resection

Martini, Nael; Starzynski, Thaddeus E.; Beattie, Edward J.

doi:10.1016/s0039-6109(16)38790-4

Cited by 24 publications

(1 citation statement)

References 34 publications

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“…The pleural space is a pressure-transmitting potential space which ultimately determines lung volume and cardiovascular performance [19]. In addition to innervated contractile muscle, the 2 essentials for effective pleural mechanics are wall stability and atmospheric seal [2,5,10,11,24]. Breach in either must be repaired, otherwise negative inspiratory pressure is lost and ineffectual breathing ensues.…”

Section: Anatomy and Physiologymentioning

confidence: 99%

An approach to repair of radiation necrosis of chest wall and mammary gland

Sando

Jurkiewicz

1986

World j. surg.

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Chest wall reconstruction following radiation no longer need be a protracted sequence of multiple stage tissue transfer with potential necrosis of the flap at each step. Muscle flaps with or without the overlying skin provide very reliable and effective methods of single-stage repair. For the anterior chest the latissimus dorsi, the rectus abdominis, and pectoralis muscles are the choices with omentum as an alternative in salvage cases. For the posterior chest, choices are the latissimus dorsi or trapezius.In selected patients, breast reconstruction can be offered. The use of either the rectus abdominis or latissimus dorsi musculocutaneous flap, singly or in tandem, is the current preferred choice.In the treatment of primary, recurrent, and unresectable chest wall malignancies [1] (e.g., breast [2-17], lung [5], chest wall tumors [8,18], deeply infiltrating skin tumors [10,19]), metastatic disease (e.g., pulmonary seminoma [6]), spinal cord and column metastases (e.g., breast, lung), or primary mediastinal tumors (e.g., lymphoma) [1,20,21], chest wall irradiation is useful and essential. Risks of therapy include not only damage to underlying lung parenchyma, mediastinal viscera, and chest wall and its overlying skin, but also the induction of neoplasia in these sites [3,13,22,23].These hazards of radiation therapy have been observed in virtually every tissue system. Particularly sensitive are those structures with high cellular turnover rates, e.g., breast, bone marrow, and thyroid [3,23]. The first 2 of these are primary constituents of the chest wall. Restoration of the radiation-injured chest wall often requires signifi-Reprint requests:

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