Muhammad Shoaib Nabi, Aamir Bilal, Fareed Ahmad Khan, Ijaz A, Rana O A, Randahawa F A, Khalil A, Raza H, Sindhu S Hn, Farooq U, Jawed F, Farooq K, Sheeraz A, Ansari H H.
Surgical treatment of chest wall tumors (resection and reconstruction) A six years experience.
Ann King Edward Med Uni Jan ;10(1):4-8.

Background: Chest wall resection and reconstruction remains one of the most challenging areas of Thoracic & Plastic Surgery. The purpose of this study is to report our 6-year experience with chest wall resections and reconstructions. Methods: A retrospective review of 36 patients who had chest wall resections from 1998 to 2003 was performed. Result: Patient demographics included tobacco abuse, hypertension, diabetes mellitus, niswar abuse, coronary artery disease, chronic obstructive pulmonary disease, and HCV +ve. Surgical indications included chest wall tumors, and lung cancer involving the chest wall. The mean number of ribs resected was 4±2 ribs. Thirty four patients underwent chest wall resections. Two patients underwent right upper lobectomy along with chest wall resections. Immediate closure was performed in all 36 patients. Primary repair without the use of reconstructive techniques was possible in 9 patients. Synthetic chest wall reconstruction was performed using Prolene mesh, Marlex mesh, methyl methacrylate sandwich, and polytetrafluoroethylene. Flaps utilized for soft tissue coverage were pedicled flaps (2 patients). Mean postoperative length of stay was 14±12 days. Mean intensive care unit stay was 5+4 days. In-hospital and 30-day survival was 100%. Conclusions: Chest wall resection with reconstruction can be performed as a safe, effective one-stage surgical procedure for a variety of major chest wall defects.

USER COMMENTS

Unfortunately discussing an article based on the abstract is moot. However the abstract should provide some idea as to why these resections were carried out. In case of malignanct tumors- the primary end point is not cosmetic but an oncologically sound resection. As such it is important to provide a londer term survival as well as local recurrence rates. Did any of these patients (with malignancies) undergo adjuvant treatment?
Posted by: oncoman on Sep 2004

I WANT TO CONGRATULATE THE AUTHORS ON THEIR WORK DONE ON CHEST WALL TUMORS. IT APPEARS FROM THE ABSTRACT THAT THE MAJORITY OF THE REPAIRS WERE DONE USING SYNTHETIC MATERIALS. IN ONLY 9 PATIENTS WAS PRIMARY REPAIR DONE WITHOUT USING ANY SYNTHETIC MATERIAL. i WOULD LIKE TO FIND OUT WHAT SHORT TERM OR L;ONG TERM COMPLICATIONS WERE SEEN , IF ANY, AMONG THE PATIENTS UNDERGOING SUCH REPAIRS.OUR EXPERIENCE WITH SYNTHETIC MESH REPAIRS IS ONLY A LIMITED ONE AND WE PREFER TO CLOSE CHEST WALL DEFECTS USING MUSCLE ADVANCEMENTS OR PEDICLE FLAPS. THE OTHER THING LACKING IS LONG TERM SURVIVAL AMONG THESE PATIENTS. THANK YOU DR. TANVEER AHMAD
Posted by: tanwir on Oct 2004

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