title: Reconstruction of the chest wall and the diaphragm using the inverted Y Marlex methylmethacrylate sandwich flap.
abstract: OBJECTIVE
  Chest wall resection and reconstruction is a demanding operation involving a dedicated team. It can be performed with minimal mortality with excellent cosmetic and functional results using various substitutes. However, reconstructing the lower costal margin with diaphragmatic resection is a challenging prospect needing special techniques.
  
  
  METHODS
  We describe a technique of reconstructing the chest wall defect involving the lower costal margin and diaphragm with an Inverted Y Marlex Methylmethacrylate Sandwich Flap.
  
  
  RESULTS
  There were no intra operative or postoperative complications and immediate extubation was possible in all six patients without the need for postoperative ventilation. There was a good functional and cosmetic result in all the patients.
  
  
  CONCLUSIONS
  This is an easy and safe technique resulting in a stable and satisfactory reconstruction after large antero-lateral full-thickness chest wall resections involving the diaphragm.
authors.affiliation: Regional Department of Thoracic Surgery, Birmingham Heartlands Hospital, Birmingham, UK. srathinam@rcsed.ac.uk
authors.forename: Sridhar
authors.initials: S
authors.lastname: Rathinam
authors.forename: Rajamiyer
authors.initials: R
authors.lastname: Venkateswaran
authors.forename: Pala B
authors.initials: PB
authors.lastname: Rajesh
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Collins
mesh_terms: D000328:Adult; D003964:Diaphragm / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D020366:Methylmethacrylate; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012509:Sarcoma / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000601:surgery; D013524:Surgical Flaps; D013526:Surgical Mesh; D035441:Thoracic Wall / Q000601:surgery*
chemical_list: D020366:Methylmethacrylate