A Twelve-Year Consecutive Case Experience in Thoracic Reconstruction

Overview

Journal Plast Reconstr Surg Glob Open

Specialty General Surgery

Date 2016 Jun 4

PMID 27257568

Citations 1

Authors

Jenny T Chen

Laura A Bonneau

Tracey L Weigel

James D Maloney

Francisco Castro

Nikita Shulzhenko

Michael L Bentz

Affiliations

Soon will be listed here.

Abstract

Background: We describe the second largest contemporary series of flaps used in thoracic reconstruction.

Methods: A retrospective review of patients undergoing thoracomyoplasty from 2001 to 2013 was conducted. Ninety-one consecutive patients were identified.

Results: Thoracomyoplasty was performed for 67 patients with intrathoracic indications and 24 patients with chest wall defects. Malignancy and infection were the most common indications for reconstruction (P < 0.01). The latissimus dorsi (LD), pectoralis major, and serratus anterior muscle flaps remained the workhorses of reconstruction (LD and pectoralis major: 64% flaps in chest wall reconstruction; LD and serratus anterior: 85% of flaps in intrathoracic indication). Only 12% of patients required mesh. Only 6% of patients with <2 ribs resected required mesh when compared with 24% with 3-4 ribs, and 100% with 5 or more ribs resected (P < 0.01). Increased rib resections required in chest wall reconstruction resulted in a longer hospital stay (P < 0.01). Total comorbidities and complications were related to length of stay only in intrathoracic indication (P < 0.01). Average intubation time was significantly higher in patients undergoing intrathoracic indication (5.51 days) than chest wall reconstruction (0.04 days), P < 0.05. Average hospital stay was significantly higher in patients undergoing intrathoracic indication (23 days) than chest wall reconstruction (12 days), P < 0.05. One-year survival was most poor for intrathoracic indication (59%) versus chest wall reconstruction (83%), P = 0.0048.

Conclusion: Thoracic reconstruction remains a safe and successful intervention that reliably treats complex and challenging problems, allowing more complex thoracic surgery problems to be salvaged.

Citing Articles

Aesthetic Contouring of the Chest wall with Rib Resection.

Ferreira L, Ferreira P, Bernardes A, Dos Anjos G, Cosac O, Willhelm R Aesthetic Plast Surg. 2020; 45(3):1099-1104.

PMID: 33037473 DOI: 10.1007/s00266-020-01988-5.

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