Chest Wall Tumors: A Spectrum of Different Pathologies and Outcomes of Reconstruction Techniques

Mohammed Sanad; Mohammed Adel Hegazy; Mohammed  ELshabrawy Saleh

doi:10.35810/ects.v2i3.138

Mohammed Sanad Cardiothoracic Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt https://orcid.org/0000-0002-0783-2323
Mohammed Adel Hegazy Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt https://orcid.org/0000-0002-2482-718X
Mohammed ELshabrawy Saleh Cardiothoracic Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

DOI: https://doi.org/10.35810/ects.v2i3.138

Keywords: Chest wall tumors, Resection, Reconstruction

Abstract

Background: Chest wall resection and further reconstruction for tumors represent a challenging concept for surgeons. Thanks to the evolving reconstruction techniques, good results were obtained after extensive resection and reconstruction.

Patients and methods: This prospective cohort study was conducted at our University Hospitals throughout 5 years. A total of 43 eligible cases with chest wall tumors were included. All cases were subjected to a multidisciplinary team approach, complete history taking, physical examination, radiological evaluation, and biopsy. The details of surgical techniques, complications, and follow up parameters were included.

Results: The mean age of the included cases was 29.45 years. We included a total of 24 males (55.8%). Fibromatosis was the commonest encountered pathology (27.9%), followed by chondrosarcoma (25.5%), and osteosarcoma (21%). Regarding the method of reconstruction, polypropylene mesh was used in 46.5% of cases, followed by direct closure (30.2%). Ten cases were managed by Methyl Methacrylate within the proline mesh (23.3%), while superimposed muscle flap was performed in only 2 cases (4.6%). Post-operatively, bleeding was encountered in 5 cases collectively (11.6%), while wound infection occurred in 11.6% of cases. Pulmonary complications included pneumonia (2.3%) and atelectasis (11.6%). Furthermore, chest wall instability was present in (11.6%) of cases. On follow up, recurrence was diagnosed in (9.3%) of cases (n = 4).

Conclusion: Surgical intervention is very effective if tailored to every patient as per team paln. A multidisciplinary team approach is extremely important especially if an extensive demolition is required. Indeed, radical wide en-bloc resection can achieve satisfactory results provided that the extent of resection is not influenced by any anticipated reconstruction problems.

Author Biographies

Mohammed Sanad, Cardiothoracic Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Lecturer of Cardiothoracic Surgery, Mansoura University, Egypt.

Member of the EACTS, STS, ISMICS, ESCTS.

Mohammed Adel Hegazy, Anesthesia and Surgical Intensive Care Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

European diploma of anesthesia and intensive care; european society of anesthesia: brussels, BE.

Lecturer of Anesthesia and surgical intnensive care, Mansoura University

Mohammed ELshabrawy Saleh, Cardiothoracic Surgery Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Lecturer of Cardiothoracic Surgery, Mansoura University, Egypt.