[Resection and reconstruction of full thickness chest wall]

Abstract

Nine patients underwent full thickness chest wall resection and reconstruction in our department between January 1981 and December 1994. There were chest wall recurrence of breast cancer in 5 cases, primary chest wall chondrosarcoma in 2, primary chest wall malignant fibrous histiocytoma in 1 and metastatic sternal renal cell carcinoma in 1. Seven of 9 cases underwent partial sternal resection. Sizes of chest wall defects were from 10 x 7 cm to 15 x 14 cm. In eight cases of 9, chest wall reconstruction was by double Marlex mesh repairs and various flaps (major pectoral muscle in 3, major pectoral myocutaneous flap in 2, latissimus dorsi myocutaneous flap in 1 and pedicled omentum in 1). The last case underwent repair with rectus abdominis myocutaneous flap without mesh. There was no operative death. Postoperative complications occurred in 4 patients: partial skin necrosis in 2, skin dehiscence in 1 and respiratory failure in 1. Eight cases are alive now from 9 months to 14 years and 8 months after chest wall reconstruction. One patient with metastatic renal cell carcinoma died of recurrence 3 years after operation. Full thickness chest wall resection and reconstruction is a safe operation and may provide a long-term survival.