Early and long-tern results of prosthetic chest wall reconstruction

Objective: The purpose of this report is to evaluate our results in patient s who underwent prosthetic bony reconstruction after chest wall resection, Methods: We retrospectively reviewed all patients who underwent chest wall resection and reconstruction with prosthetic material at the Mayo Clinic. R esults: From January 1, 1977, to December 31, 1992, 197 patients (109 male patients and 88 female patients) underwent chest wall resection and reconst ruction with prosthetic material. Median age was 59 years (range, 11-86 yea rs). The indication for resection was recurrent chest wall malignancy in 65 patients (33.0%), primary chest wall malignancy in 62 patients (31.5%), co ntiguous lung or breast carcinoma in 58 patients (29.4%), and other reasons in 12 patients (6.1%), Three patients (1.5%) each had an open draining wou nd, This review covers 2 time periods, Sixty-four patients (32.5%) underwen t reconstruction with polypropylene mesh during the period from 1977 to 198 6, One hundred thirty-three patients (67.5%) underwent reconstruction with polytetrafluoroethylene from 1984 to 1992. Soft tissue coverage was achieve d with transposed muscle in 116 patients (58.9%), local tissue in 81 patien ts (41.1%), and omentum in 3 patients (1.5%), There were 8 deaths (operativ e mortality rate, 4.1%), Ninety-one patients (46.2%) experienced complicati ons. Seromas occurred in 14 patients (7.1%), Wound infections occurred in 9 patients (4.6%; 5 patients with polypropylene mesh and 4 patients with pol ytetrafluoroethylene), The prosthesis was removed in all 5 patients with po lypropylene mesh and in none of the patients with polytetrafluoroethylene. Follow-up was complete in 179 operative survivors (94.7%) and ranged from 1 to 204 months (median, 26 months). A well-healed asymptomatic wound was pr esent in 127 patients (70.9%), Conclusions: Chest wall resection and recons truction with prosthetic material will yield satisfactory results in most p atients. Little difference exists between polypropylene mesh and polytetraf luoroethylene.