Principles of chest wall resection and reconstruction.
Despite significant improvements in surgical technique and perioperative care, the management of patients requiring chest wall resection and reconstruction is an ongoing challenge for thoracic surgeons. A successful approach includes a thorough assessment of the patient and the lesion, an adequate biopsy to confirm tissue diagnosis, and a well-established treatment plan. In the case of a primary tumor of the chest wall, the extent of the resection should not be limited by the size of the resulting defect. Following resection, chest wall reconstruction mandates an appreciation for restoration of functional and structural components. An algorithmic approach to chest wall reconstruction begins with the assessment of the nature of the defect, taking into consideration factors such as infection, tumor location, previous radiation therapy, and surgical intervention. The latter factors bear influence on the type of tissue required as well as whether reconstruction can be performed in a single stage or whether it is better delayed. Finally, patient factors including lifestyle and work, as well as prognosis, are considered to determine the best reconstructive option.
Division of Thoracic Surgery, Department of Surgery, Centre Hospitalier de l'Université de Montreal, Université de Montreal, 1560 Sherbrooke Street East, Montreal, Quebec H2L 4M1, Canada. pasquale.ferraro@umontreal.ca
Pasquale
P
Ferraro
Sabrina
S
Cugno
Moishe
M
Liberman
Michel Alain
MA
Danino
Patrick G
PG
Harris
D044963:Biopsy, Fine-Needle; D005354:Fibrosarcoma / Q000601:surgery; D006801:Humans; D011126:Polypropylenes; D019651:Plastic Surgery Procedures / Q000379:methods*; D012983:Soft Tissue Neoplasms / Q000145:classification / Q000601:surgery*; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000145:classification / Q000601:surgery*; D035441:Thoracic Wall / Q000601:surgery*
D011126:Polypropylenes