Chest wall reconstruction with a methyl-methacrylate sandwich after resection of large chest wall tumors: single center experience

Document Type : Original Article

Authors

1 Cardiothoracic Surgery, Faculty of medicine,Sohag University,Sohag,Egypt

2 anesthesia and ICU department ,Sohag Faculty of medicine , Sohag University , Sohag, Egypt.

Abstract

Background: The advantages of methyl-methacrylate sandwich for chest wall reconstruction are controversial. We aimed to report the outcomes of chest wall reconstruction using a methyl-methacrylate sandwich after large tumor resection.
Methods: This retrospective research included 30 patients who had chest wall reconstruction after resection of large tumors from January 2010 to December 2018 at a single center. All patients had skeletal reconstruction using a methyl-methacrylate sandwich with a Prolene mesh. Soft-tissue construction was performed with primary closure (n= 12), latissimus dorsi flap (n= 10), local flap (n= 4), and pectoralis muscle flap (n= 4).
Results: Male presented 73.3% of the patients (n=22) and the median age was 50 years (range: 20- 75). The pathology of the resected tumors were infiltrating carcinoma of the lung (n= 6; 20%), undifferentiated pleomorphic sarcoma (n= 4; 13.3%), chondrosarcoma (n= 4; 13.3%), infiltrating adenocarcinoma of mesothelial origin (n= 4; 13.3%), adenocarcinoma of lung origin (n= 2; 6.7%), osteochondroma (n= 2; 6.7%), Ewing sarcoma (n= 2; 6.7%), round cell sarcoma (n= 2; 6.7%), sternal sarcoma (n= 2; 6.7%), and chondroma (n= 2; 6.7%). Postoperative complications occurred in 14 patients; atelectasis (n= 2; 13.3%), consolidation (n= 2; 6.7%), wound infection (n= 2; 6.7%), flap seroma (n= 2; 6.7%), acute respiratory distress syndrome (n= 2; 6.7%) and local recurrence (n= 2; 6.7%). We reported two late mortalities because of distant metastasis and sepsis Conclusion: Immediate reconstruction of large chest wall defects following tumor resection could be feasible using methyl-methacrylate filler with synthetic mesh with accepted morbidity and mortality.

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