title: Thoracic wall reconstruction with bioabsorbable plates in pediatric malignant thoracic wall tumors.
abstract: OBJECTIVE
  Childhood malignant chest wall tumors may require extensive surgical resection and reconstruction with musculoskeletal flaps or non-resorbable prosthetic materials. Implant-related complications and scoliosis often occur. This study analyzes the outcomes of chest wall reconstruction using resorbable plates as an alternative approach.
  
  
  METHODS
  Retrospective review (2007-2015) of patients who underwent resection of malignant primary chest wall tumors in 2 tertiary pediatric centers. Reconstruction was performed using copolymer (l-lactic and glycolic acid) plates, fixed to the ribs and surrounding structures with copolymer screws and/or polyglactin sutures.
  
  
  RESULTS
  Eight patients aged 10.6+2.6years were treated. There were no operative complications, and implant removal was not required in any case. Six patients received postoperative radiotherapy. Over follow-up (39.6months, range 9.4-78), chest wall shape was maintained in all, and there were no radiological artifacts. Three patients developed scoliosis (Cobb 17°-33°), but treatment was needed only in one, who had undergone hemivertebrectomy. There were no cases of local tumor relapse. One patient died because of metastatic spread.
  
  
  CONCLUSIONS
  Implantation of bioabsorbable l-lactic and glycolic acid copolymer plates with a relatively simple technique provided a rigid, stable reconstruction with only mild mid-/long-term complications. Resorbable plates may be a good alternative for pediatric chest wall reconstruction.
  
  
  METHODS
  IV.
authors.affiliation: Pediatric Surgery Department, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: gguillen@vhebron.net.
authors.forename: G
authors.initials: G
authors.lastname: Guillén
authors.affiliation: Pediatric Surgery Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: García
authors.affiliation: Pediatric Surgery Department, Hospital Son Espases, Palma de Mallorca, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Marhuenda
authors.affiliation: Orthopedics Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Pellisé
authors.affiliation: Pediatric Surgery Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Molino
authors.affiliation: Orthopedics Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: C G
authors.initials: CG
authors.lastname: Fontecha
authors.affiliation: Pediatric Surgery Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: López
authors.affiliation: Pediatric Surgery Department, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Lloret
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery; D012512:Sarcoma, Ewing / Q000601:surgery*; D012600:Scoliosis / Q000209:etiology; D013899:Thoracic Neoplasms / Q000601:surgery*; D019616:Thoracic Surgical Procedures; D035441:Thoracic Wall / Q000601:surgery*
keywords: Bioabsorbable implants; Chest wall; Ewing's sarcoma; Osteosarcoma; Pediatrics; Scoliosis