Sternal resection and reconstruction after malignant tumours

Aim We present our experience of the resection of sternal tumours (both primary and metastatic), followed by reconstruction of soft-tissue and skeletal defects with a mesh and musculocutaneous flap. Methods Eleven patients were included in this study, all of which underwent sternal tumour resection...

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Bibliographic Details
Published in:Clinical & translational oncology 2009-02, Vol.11 (2), p.91-95
Main Authors: Galbis Caravajal, José M., Sánchez, Luis Yeste, Fuster Diana, Carlos A., Jorge, Ricardo Guijarro, Ortiz, Paula Fernández, Deaville, Pam J.
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasms - surgery
Oncology
Reconstructive Surgical Procedures - mortality
Sternum - pathology
Sternum - surgery
Surgical Flaps
Surgical Mesh
Thoracic Wall - surgery
Treatment Outcome
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Summary:Aim We present our experience of the resection of sternal tumours (both primary and metastatic), followed by reconstruction of soft-tissue and skeletal defects with a mesh and musculocutaneous flap. Methods Eleven patients were included in this study, all of which underwent sternal tumour resection and immediate chest wall repair. Reconstruction was accomplished with prosthetic material (polytetrafluoroethylene [PTFE]), a sandwich of polypropylene (Marlex-methylmethacrylate or titanium/polypropylene) and a pedicled musculocutaneous flap (pectoralis major, latissimus dorsi or rectus abdominis). Sternal tumours may arise from both primary (chondrosarcoma and neurofibrosarcoma) and secondary (local recurrence of breast carcinoma and metastatic disease from other organs) disease. Results Extubation did not result in paradoxical respiration in any of the patients in the study. The post-operative mortality rate was seen to be zero. One patient with a PTFE prosthesis had chest failure requiring immediate intubation and posterior prosthesis replacement. One mesh was removed two months after surgery. There was local recurrence in one patient and five patients died from distal metastases. The final patient is still alive with metastases at the time of presenting our results. Conclusions Wide resection of sternal tumours provides good local control. Reconstruction with mesh and musculocutaneous flap is an effective technique for repairing such defects.
ISSN:1699-048X
1699-3055
DOI:10.1007/s12094-009-0320-3