Results of chest wall resection and reconstruction with and without rigid prosthesis Journal Article
| Authors: | Weyant, M. J.; Bains, M. S.; Venkatraman, E.; Downey, R. J.; Park, B. J.; Flores, R. M.; Rizk, N.; Rusch, V. W. |
| Article Title: | Results of chest wall resection and reconstruction with and without rigid prosthesis |
| Abstract: | Background. Chest wall resections are associated with significant morbidity, with respiratory failure in as many as 27% of patients. We hypothesized that our selective use of a rigid prosthesis for reconstruction reduces respiratory complications. Methods. The records of all patients undergoing chest wall resection and reconstruction were reviewed. Patient demographics, use of preoperative therapy, the location and size of the chest wall defect, performance of lung resection if any, the type of prosthesis, and postoperative complications were recorded. Predictor of complications were identified by χ2 and logistic regression analyses. Results. From January 1, 1995, to July 1, 2003, 262 patients (median age, 60 years) underwent chest wall resection for tumor in 251 (96%), radiation necrosis in 7 (2.7%); and infection in 4 patients (1.3%). The median defect size was 80 cm2 (range, 2.7 to 1,200 cm2) and the median number of ribs resected was 3 (range, 1 to 8). Major lung resection was performed in 85 patients (34%). Prosthetic reconstruction was rigid (polypropylene mesh/methylmethacrylate composite) in 112 (42.7%), nonrigid (polytetrafluoroethylene or polypropylene mesh) in 97 (37%), and none in 53 patients. Postoperatively, 10 patients died (3.8%), 4 of whom had pneumonectomy plus chest wall resection. Respiratory failure occurred in 8 patients (3.1%). By multivariate analysis, the size of the chest wall defect was the most significant predictor of complications. Conclusions. Our incidence of respiratory failure is lower than previously reported and may relate to our use of rigid repair for defects likely to cause a flail segment. Pneumonectomy plus chest wall resection should be performed only in highly selected patients. © 2006 by The Society of Thoracic Surgeons. |
| Keywords: | adult; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; reconstructive surgical procedures; retrospective studies; major clinical study; review; plastic surgery; postoperative period; preoperative care; demography; infection; lung resection; pneumonectomy; incidence; device removal; prediction; pneumonia; postoperative complication; postoperative complications; thoracic neoplasms; medical record; atelectasis; multivariate analysis; equipment design; logistic regression analysis; time series analysis; prosthesis; politef; thorax surgery; surgical mesh; thoracic wall; radiation necrosis; performance; respiratory failure; prostheses and implants; prosthesis implantation; radiodermatitis; polytetrafluoroethylene; respiratory distress syndrome, adult; methacrylic acid methyl ester; polypropylene; flail chest; methylmethacrylate; polypropylenes |
| Journal Title: | Annals of Thoracic Surgery |
| Volume: | 81 |
| Issue: | 1 |
| ISSN: | 0003-4975 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2006-01-01 |
| Start Page: | 279 |
| End Page: | 285 |
| Language: | English |
| DOI: | 10.1016/j.athoracsur.2005.07.001 |
| PUBMED: | 16368380 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 54" - "Export Date: 4 June 2012" - "CODEN: ATHSA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work