Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1988 Jun;207(6):707–716. doi: 10.1097/00000658-198806000-00010

Reconstruction of full thickness chest wall defects.

R F Morgan 1, M T Edgerton 1, H J Wanebo 1, T M Daniel 1, W D Spotnitz 1, I L Kron 1
PMCID: PMC1493548  PMID: 3389939

Abstract

Over the last 5 years, 14 patients were treated by wide en bloc resection of chest wall tumors with primary reconstruction. There were nine females and five male patients with an age range of 31-77 years. All patients had a skeletal resection of the chest wall. An average of 3.9 ribs were resected in the patients treated. In three patients a partial sternectomy was carried out in conjunction with the rib resections. Chest wall skeletal defects were reconstructed with Prolene mesh, which was placed under tension. Soft tissue reconstruction utilized selected portions of the latissimus dorsi musculocutaneous territory with fasciocutaneous extensions beyond the muscle itself. Primary healing was obtained in all patients and secondary procedures were not required. The average hospitalization was 23 days. All patients survived the resection and reconstruction and were alive 30 days after operation. In selected patients the preservation of a portion of the innervated muscle in situ or the transfer of the muscle with the preservation of its resting length has maintained the majority of the muscle function.

Full text

PDF
716

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arnold P. G., Pairolero P. C. Chest wall reconstruction. Experience with 100 consecutive patients. Ann Surg. 1984 Jun;199(6):725–732. doi: 10.1097/00000658-198406000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BLADES B., PAUL J. S. Chest wall tumors. Ann Surg. 1950 Jun;131(6):976–984. doi: 10.1097/00000658-195006000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bostwick J., 3rd, Nahai F., Wallace J. G., Vasconez L. O. Sixty latissimus dorsi flaps. Plast Reconstr Surg. 1979 Jan;63(1):31–41. doi: 10.1097/00006534-197901000-00006. [DOI] [PubMed] [Google Scholar]
  4. Boyd A. D., Shaw W. W., McCarthy J. G., Baker D. C., Trehan N. K., Acinapura A. J., Spencer F. C. Immediate reconstruction of full-thickness chest wall defects. Ann Thorac Surg. 1981 Oct;32(4):337–346. doi: 10.1016/s0003-4975(10)61754-7. [DOI] [PubMed] [Google Scholar]
  5. CAMPBELL D. A. Reconstruction of the anterior thoracic wall. J Thorac Surg. 1950 Mar;19(3):456–461. [PubMed] [Google Scholar]
  6. CONVERSE J. M., CAMPBELL R. M., WATSON W. L. Repair of large radiation ulcers situated over the heart and the brain. Ann Surg. 1951 Jan;133(1):95–103. doi: 10.1097/00000658-195101000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. 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]
  8. Jurkiewicz M. J., Arnold P. G. The omentum: an account of its use in the reconstruction of the chest wall. Ann Surg. 1977 May;185(5):548–554. doi: 10.1097/00000658-197705000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. 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]
  10. 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]
  11. LEROUX B. T. MAINTENANCE OF CHEST WALL STABILITY. Thorax. 1964 Sep;19:397–405. doi: 10.1136/thx.19.5.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Larson D. L., McMurtrey M. J., Howe H. J., Irish C. E. Major chest wall reconstruction after chest wall irradiation. Cancer. 1982 Mar 15;49(6):1286–1293. doi: 10.1002/1097-0142(19820315)49:6<1286::aid-cncr2820490635>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  13. Lund F. B. VII. Sarcoma of the Chest Wall. Ann Surg. 1913 Aug;58(2):206–217. doi: 10.1097/00000658-191308000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Pairolero P. C., Arnold P. G. Thoracic wall defects: surgical management of 205 consecutive patients. Mayo Clin Proc. 1986 Jul;61(7):557–563. doi: 10.1016/s0025-6196(12)62004-7. [DOI] [PubMed] [Google Scholar]
  15. Rees T. D., Converse J. M. Surgical reconstruction of defects of the thoracic wall. Surg Gynecol Obstet. 1965 Nov;121(5):1066–1072. [PubMed] [Google Scholar]
  16. 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]
  17. Stone H. H., Fabian T. C., Turkleson M. L., Jurkiewicz M. J. Management of acute full-thickness losses of the abdominal wall. Ann Surg. 1981 May;193(5):612–618. doi: 10.1097/00000658-198105000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Zinninger M. M. TUMORS OF THE WALL OF THE THORAX. Ann Surg. 1930 Dec;92(6):1043–1058. doi: 10.1097/00000658-193012000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES