Resection of Sternal Tumors and Reconstruction of the Thorax: A Review of 15 Patients |
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Authors: | Shuji Haraguchi Masafumi Hioki Takao Hisayoshi Koji Yamashita Yasuo Yamashita Jun Kawamura Tomomi Hirata Shigeki Yamagishi Kiyoshi Koizumi Kazuo Shimizu |
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Institution: | (1) Department of Surgery, Nippon Medical School Second Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan;(2) Department of Surgery, Tohoku Rosai Hospital, Miyagi, Japan;(3) Department of Thoracic Surgery, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan;(4) Department of Surgery II, Nippon Medical School, Tokyo, Japan |
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Abstract: | Purpose We report our experience of resecting sternal tumors, followed by reconstruction of the skeletal and soft-tissue defects,
and discuss the usefulness of sandwiched Marlex and stainless-steel mesh.
Methods Fifteen patients underwent resection of a sternal tumor and chest wall reconstruction with autologous bone grafts, sandwiched
Marlex and stainless-steel mesh or a titanium plate, and musculocutaneous flaps. The sternal tumors were from locally recurrent
breast carcinoma in ten patients, metastasis from other organs in three, and primary chondrosarcoma in two.
Results All patients were extubated without paradoxical respiration just after surgery. There was no operative mortality. A wound
infection developed in the acute phase after a sandwiched Marlex and stainless-steel mesh reconstruction in one patient. A
second repair with Marlex and stainless-steel mesh was required in two patients; for flail chest after an autologous bone
graft in one; and following re-recurrence of breast carcinoma in another patient who had undergone a musculocutaneous flap
repair. No signs of breakdown, dislodgment, severe depression, or deformity were seen in any of the six patients who underwent
reconstruction with Marlex and stainless-steel mesh during a median follow-up period of 56 months.
Conclusions Wide resection of sternal tumors provides good local control. Reconstruction with Marlex and stainless-steel mesh seems to
be the most effective technique for repairing a wide anterior chest wall defect. |
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Keywords: | Sternal tumor Wide resection Marlex mesh Stainless-steel mesh |
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