Sternal reconstruction with synthetic mesh and metallic plates for high grade tumours of the chest wall.
OBJECTIVE
To present our experience of reconstruction of the chest wall after sternectomy for high grade tumours.


METHODS
Retrospective study.


METHODS
University hospital, Italy.


METHODS
18 patients who required sternectomy for high grade tumours.


METHODS
After wide resection of the tumour the sternum and chest wall were reconstructed with polypropylene (Marlex) mesh and mouldable titanium plates. Pedicled muscle flaps were used to complete the reconstruction.


METHODS
Morbidity, mortality, and outcome.


RESULTS
The 18 tumours were chondrosarcomas (n = 7); osteosarcomas, radiation-induced sarcomas, and local recurrences after breast cancer (n = 2 each); and angiosarcoma, Ewing sarcoma, liposarcoma, malignant fibrous histiocytoma, and metastatic renal carcinoma (n = 1 each). One patient died in hospital. Two patients developed wound infections, one required repeated aspirations of a pleural effusion, and one patient later developed loosening of the plate that had been sutured to the clavicular stump. At the time of follow-up (mean 32 months, range 12-74) 16 patients were alive, all of whom had returned to their normal life style.


CONCLUSIONS
The technique is easy to follow and has the advantages of a short hospital stay and good local control. It obviates the need for postoperative mechanical ventilation, and means that patients are not prevented from working because of incapacity.
Briccoli
Antonio
A
Department of General Surgery, Istituto Ortopedico Rizzoli, University of Bologna, Italy. antonio.briccoli@ior.it
Manfrini
Marco
M
Rocca
Michele
M
Lari
Stefano
S
Giacomini
Stefano
S
Mercuri
Mario
M
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D002292:Carcinoma, Renal Cell / Q000601:surgery; D002813:Chondrosarcoma / Q000601:surgery; D005260:Female; D006394:Hemangiosarcoma / Q000601:surgery; D018219:Histiocytoma, Benign Fibrous / Q000601:surgery; D006801:Humans; D008080:Liposarcoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery; D011126:Polypropylenes; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery; D012512:Sarcoma, Ewing / Q000601:surgery; D013249:Sternum / Q000601:surgery*; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000601:surgery*; D035441:Thoracic Wall; D013905:Thoracoplasty / Q000379:methods*
D011126:Polypropylenes