TECHNIQUES IN THE COMPOSITE RECONSTRUCTION OF EXTENSIVE THORACOABDOMINAL TUMOR RESECTIONS

BACKGROUND: This report illustrates the unique problems of reconstruct ing thoracoabdominal wall defects coexisting with diaphragmatic defect s. STUDY DESIGN: Two patients with extensive primary chest wall tumors (chondrosarcoma and desmoid tumor) underwent aggressive resection of the hemithorax, hemidiaphragm, and anterior chest wall for cure. The c ombined chest and abdominal wall defect was greater than 625 cm(2) in both cases. RESULTS: Functional restoration of these massive thoracoab dominal defects was accomplished by use of polypropylene-methyl methac rylate prostheses and vascularized tissue coverage. The requirements f or rigidity, protection, and esthetic contouring of the chest wall are satisfied by this reconstruction. This technique also offers the flex ibility and durability that the abdominal wall requires. Repair of the diaphragm using this technique is secure and simple. CONCLUSIONS: Our report confirms the principle that, with modern thoracic and plastic operative techniques, the extent of tumor resection should not be comp romised because of concern over the ability to reconstruct the defect.