Details
Category: Volume 07 Issue 02 February 2019
Hits: 1294

Title: Chest Wall Tumor Resection and Reconstruction – Our Technique of Fixing the Prolene Mesh

Authors: Dr Nimish Rai, Dr Uday Narayan Sarkar, Dr Nidhi Rai

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.137

Abstract

The common indications for chest wall reconstruction include tumor, infection, congenital abnormalities, radiation injury, and trauma. The goals of successful reconstruction are to restore the chest wall rigidity, preserve pulmonary mechanics, protect intrathoracic organs, minimise the thoracic deformity. Large defects need synthetic, biologic or composite mesh reinforced by direct suture or flaps.

In last 10 years we have done 26 cases of chest wall tumor, of these 17 patients required reconstruction. We resected the tumor with margins as per oncological guidelines. To cover the defect Prolene mesh was used reinforced by muscle or myocutaneous flap. In our technique of reconstruction, we made a rim at resected margin to put the mesh. Preparation of rim around the margins taking all available tissue is of utmost importance. An average number of ribs resected were 3 per patient. All patients operated had uneventful recovery.

Keywords: chest wall tumor, Rim, Prolene mesh.

References

  1. Tukiainen. Chest Wall Reconstruction after Oncological Resections. Scand J Surg. 2013;102(1):9-13.
  2. Mark W. Clemens, Karen K. Evans, Samir Mardini, Phillip G. Arnold Introduction to Chest Wall Reconstruction: Anatomy and Physiology of the Chest and Indications for Chest Wall Reconstruction, Semin Plast Surg. 2011 Feb; 25(1): 5–15.
  3. Ting V, Pribaz, J: Free flaps for chest wall reconstruction. In: Reconstructive Surgery of the Chest, Abdomen and Pelvis. Ed. Evans Gregory. Marcel Dekker, 2004
  4. Tensini I. Sopra il mio nuovo processo di amputazione della mammella. Gazzetta Med Ital 1906;57:141-2.
  5. Seder CW, Rocco G. Chest wall reconstruction after extended resection. J Thorac Dis 2016;8:S863-S871.
  6. Stefano Sanna, Jury Brandolini, Alessandro Pardolesi, et al. Materials and techniques in chest wall reconstruction: a review J Vis Surg. 2017; 3: 95.
  7. Tukiainen E, Popov P, Asko-Seljavaara S. Microvascular reconstructions of full-thickness oncological chest wall defects. Ann Surg 2003;238:794-801.
  8. Weyant MJ, Bains MS, Venkatraman E, et al. Results of chest wall resection and reconstruction with and without rigid prosthesis. Ann Thorac Surg 2006;81:279-85.
  9. Deschamps C, Tirnaksiz BM, Darbandi R, et al. Early and long-term results of prosthetic chest wall recontruction. J Thorac Cardiovasc Surg 1999;117:588-91
  10. Elizabeth A. David, Blair Marshall Review of Chest Wall Tumors: A Diagnostic, Therapeutic, and Reconstructive Challenge, Semin Plast Surg. 2011 Feb; 25(1): 16–24.
  11. Osada H. Yokote K : Indication and method of cest wall reconstruction. Kyobu Geka1996; Jan49(1):38-41
  12. Takeshi Nagayasu, Naoya Yamasaki, Tsutomu Tagawa et al. Long-term results of chest wall reconstruction with DualMesh Interactive CardioVascular and Thoracic Surgery, Volume 11, Issue 5, 1 November 2010, Pages 581–584,
  13. Arnold, PG, Pairolero, PC: Chest wall reconstruction. An account of 500 consecutive patients. Plast Reconstr Surg. 1996;98: 804–810
  14. Mansour, KA, Thourani, VH, Losken, An: Chest wall resections and reconstructions: a 25-year experience. Ann Thorac Surg 2002: 73: 1720–1725

Corresponding Author

Dr Nidhi Rai

301, Anika Apartment, Near Shastri Bridge, Napier Town, Jabalpur, M.P. 482001, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.