Experience of chest wall tumor resection and chest wall defect reconstruction

Objective To investigate the resection of chest wall tumor and the reconstruction of it. Methods Retrospectively summarize the diagnosis and treatment of 91 cases of chest wall tumors in our hospital from January 2008 to November 2017. There are 55 males and 36 females and the ages ranged from 7 to 78 years, with a median age of 43 years. 82 cases were operated for the first time, and 9 cases were reoperated. The postoperative pathology showed that the benign were 52 cases and malignant were 39 cases. The largest benign tumor was 15 cm×10 cm×3 cm and the largest malignant tumor was 30 cm×20 cm×15 cm. Local excision was performed in 66 cases and extended resection in 25 cases. After the resection, ilium, titanium mesh, Dacron mesh and Matrix reconstruction system were selected for reconstruction of chest wall respectivly. Results All the operation was successful and without death. Local resection was performed in all of benign tumor and in 15 cases of malignant tumor, extended resection was performed in the other 24 malignant tumor cases. After the local resection, the soft tissue was sutured directly to reconstruct the chest wall. The enlarged resection of the bone was performed by reconstructing the bony chest with different materials. In the soft tissue reconstruction, 1 cases were treated with myocutaneous flap, and the other 23 cases were sutured directly. Postoperative chest wall integrity is stable, no chest wall floating and abnormal breathing. 1 patients received ventilator supportion, and 2 patients had wound infection. The chest wall defect caused by benign tumor has good quality of life, no recurrence. After resection of the malignant tumor of the chest wall, 2 died, and the rest were still alive. Conclusion Local resection is the main therapeutic method of benign chest wall tumor, and malignant chest wall tumor is mostly enlarged excision. Bone remodeling after extended resection plays an important role in the reconstruction of chest wall. It is necessary to select appropriate materials for reconstruction. Matrix titanium sternal or rib reconstruction system fixed reliably and the follow-up in a short term were also satisfactory. Key words: Thoracic wall; Neoplasms; Thoracic surgical procedures