Abstract
Ten patients with lesions of the chest wall amenable to surgical therapy were reconstructed by a transposition flap of the greater omentum. Eight of these patients had been previously treated for cancer of the female breast by mastectomy and irradiation or by irradiation alone (in one instance). Of these 8, 6 had progressive ulceration of the chest wall consistent with radiation necrosis and three had residual carcinoma within the ulcer. One patient had melanoma of the chest wall still persistent after surgical resection and irradiation. Another had epidermoid carcinoma, whereas two sought breast reconstruction after successful mastectomy for cancer. In five patients the omentum was transposed directly on the pleura and lung or chest wall. In three patients prolene mesh was interposed to stabilize the chest wall. In two patients the defect attendant upon a Halsted mastectomy was ameliorated by a one-stage reconstruction using transposed omentum to cover a silastic gel prosthesis and to support an overlying skin graft. In three patients there were mild transient symptoms of gastric outlet obstruction postoperatively. In one patient delayed healing occurred because of partial separation of the omentum from the underlying irradiated pleura and in another there was partial loss of skin graft and omentum due to hematoma. A closed wound was achieved in all cases without infection.
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- ABBOTT L. C., LUCAS D. B. The function of the clavicle; its surgical significance. Ann Surg. 1954 Oct;140(4):583–599. doi: 10.1097/00000658-195410000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Alday E. S., Goldsmith H. S. Surgical technique for omental lengthening based on arterial anatomy. Surg Gynecol Obstet. 1972 Jul;135(1):103–107. [PubMed] [Google Scholar]
- BAKAMJIAN V. Y. A TWO-STAGE METHOD FOR PHARYNGOESOPHAGEAL RECONSTRUCTION WITH A PRIMARY PECTORAL SKIN FLAP. Plast Reconstr Surg. 1965 Aug;36:173–184. doi: 10.1097/00006534-196508000-00004. [DOI] [PubMed] [Google Scholar]
- BAUE A. E. Total resection of the sternum. J Thorac Cardiovasc Surg. 1963 Apr;45:559–563. [PubMed] [Google Scholar]
- Brown R. G., Vasconez L. O., Jurkiewicz M. J. Transverse abdominal flaps and the deep epigastric arcade. Plast Reconstr Surg. 1975 Apr;55(4):416–421. [PubMed] [Google Scholar]
- CAMPBELL D. A. Reconstruction of the anterior thoracic wall. J Thorac Surg. 1950 Mar;19(3):456–461. [PubMed] [Google Scholar]
- Das S. K. The size of the human omentum and methods of lengthening it for transplantation. Br J Plast Surg. 1976 Apr;29(2):170–144. doi: 10.1016/0007-1226(76)90045-x. [DOI] [PubMed] [Google Scholar]
- GRAHAM J., USHER F. C., PERRY J. L., BARKLEY H. T. Marlex mesh as a prosthesis in the repair of thoracic wall defects. Ann Surg. 1960 Apr;151:469–479. doi: 10.1097/00000658-196004000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Groves E. W. The Radical Operation for Cancer of the Pylorus, with especial reference to the Advantages of the Two-stage Operation and to the Question of the Removal of the Associated Lymphatics. Proc R Soc Med. 1910;3(SURG):117–164. doi: 10.1177/003591571000301615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KIRICUTA I. [The use of the great omentum in the surgery of breast cancer]. Presse Med. 1963 Jan 5;71:15–17. [PubMed] [Google Scholar]
- KIRKLIN J. W., MYRE T. T. Resection of tumors of the sternum. Ann Surg. 1956 Dec;144(6):1023–1028. doi: 10.1097/00000658-195612000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MALONEY J. V., Jr, SCHMUTZER K. J., RASCHKE E. Paradoxical respiration and "pendelluft". J Thorac Cardiovasc Surg. 1961 Mar;41:291–298. [PubMed] [Google Scholar]
- Martini N., Starzynski T. E., Beattie E. J., Jr Problems in chest wall resection. Surg Clin North Am. 1969 Apr;49(2):313–322. doi: 10.1016/s0039-6109(16)38790-4. [DOI] [PubMed] [Google Scholar]
- Powers J. C., Fitzgerald J. F., McAlvanah M. J. The anatomic basis for the surgical detachment of the greater omentum from the transverse colon. Surg Gynecol Obstet. 1976 Jul;143(1):105–106. [PubMed] [Google Scholar]
- Starzynski T. E., Snyderman R. K., Beattie E. J., Jr Problems of major chest wall reconstruction. Plast Reconstr Surg. 1969 Dec;44(6):525–535. doi: 10.1097/00006534-196912000-00001. [DOI] [PubMed] [Google Scholar]
- Tai Y., Hasegawa H. A transverse abdominal flap for reconstruction after radical operations for recurrent breast cancer. Plast Reconstr Surg. 1974 Jan;53(1):52–54. doi: 10.1097/00006534-197401000-00009. [DOI] [PubMed] [Google Scholar]