title: Sternal resection and reconstruction after malignant tumours.
abstract: OBJECTIVE
  We present our experience of the resection of sternal tumours (both primary and metastatic), followed by reconstruction of soft-tissue and skeletal defects with a mesh and musculocutaneous flap.
  
  
  METHODS
  Eleven patients were included in this study, all of which underwent sternal tumour resection and immediate chest wall repair. Reconstruction was accomplished with prosthetic material (polytetrafluoroethylene [PTFE]), a sandwich of polypropylene (Marlex-methylmethacrylate or titanium/polypropylene) and a pedicled musculocutaneous flap (pectoralis major, latissimus dorsi or rectus abdominis). Sternal tumours may arise from both primary (chondrosarcoma and neurofibrosarcoma) and secondary (local recurrence of breast carcinoma and metastatic disease from other organs) disease.
  
  
  RESULTS
  Extubation did not result in paradoxical respiration in any of the patients in the study. The post-operative mortality rate was seen to be zero. One patient with a PTFE prosthesis had chest failure requiring immediate intubation and posterior prosthesis replacement. One mesh was removed two months after surgery. There was local recurrence in one patient and five patients died from distal metastases. The final patient is still alive with metastases at the time of presenting our results.
  
  
  CONCLUSIONS
  Wide resection of sternal tumours provides good local control. Reconstruction with mesh and musculocutaneous flap is an effective technique for repairing such defects.
authors.affiliation: Department of Thoracic Surgery, General Universitary Hospital of Valencia, Valencia, Spain. josegalbiscar@gmail.com
authors.forename: J M
authors.initials: JM
authors.lastname: Galbis Caravajal
authors.forename: L
authors.initials: L
authors.lastname: Yeste Sánchez
authors.forename: C A
authors.initials: CA
authors.lastname: Fuster Diana
authors.forename: R
authors.initials: R
authors.lastname: Guijarro Jorge
authors.forename: P
authors.initials: P
authors.lastname: Fernández Ortiz
authors.forename: P J
authors.initials: PJ
authors.lastname: Deaville
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000401:mortality; D013249:Sternum / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D013526:Surgical Mesh; D035441:Thoracic Wall / Q000601:surgery; D016896:Treatment Outcome