Reconstruction of the Chest Wall During Extensive Resections. Literature Review. Own Experience

Abstract

Tumors of the chest wall are a relatively rare disease in clinical practice. Most published studies of chest wall tumors are typically single-center, retrospective studies involving small numbers of patients. Thus, evidence for clinical findings regarding chest wall tumors is currently lacking. The article reviews the literature and highlights the epidemiology of chest wall tumors. The types of materials for reconstruction, the methods used for chest wall plastic surgery for extensive resections, and complications are described in detail. The authors presented their own experience in treating 42 patients who, for one reason or another, underwent resection of the bone structures of the breast. According to the etiology, the tumors were divided into: non-small cell lung cancer with invasions into the chest wall (9 patients, 21.4 %), invasion of breast cancer (2 patients, 4.8 %), sarcomas (chondrosarcomas, osteosarcomas, soft tissue sarcomas; 13 patients, 31 %), metastases of malignant tumors of various origins and localization (9 patients, 21.4 %), benign tumors (8 patients, 19 %), dysmoid tumor (1 patient, 2.4 %). 22 (52.3 %) patients underwent plastic surgery of the resulting defect. Of these, myoplasty, plastic surgery with a diaphragm, local tissues (8 patients, 36.4 %), alloplasty with a polypropylene mesh (6 patients, 27.3 %), alloplasty with a polymer plate (7 patients, 16.7 %). In 3 cases, alloplasty was supplemented by replacement of soft tissues with a thoracodorsal flap. The methods of plastic surgery and the materials used are described. In the postoperative period, the authors did not observe complications associated with paradoxical breathing.