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Thorac Cardiovasc Surg 2020; 68(04): 341-351
DOI: 10.1055/s-0039-1694033
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Anterior Chest Wall Reconstruction Using Polypropylene Mesh: A Retrospective Study

Alexander Schroeder-Finckh
1   Lung Clinic, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
,
Alberto Lopez-Pastorini
1   Lung Clinic, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
,
Thomas Galetin
1   Lung Clinic, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
,
Jerome Defosse
2   Clinic for Anaesthesiology and Operative Intensive Medicine, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
,
Erich Stoelben
1   Lung Clinic, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
,
Aris Koryllos
1   Lung Clinic, Hospital Cologne-Merheim, Witten/Herdecke University, Köln, Nordrhein-Westfalen, Germany
› Author Affiliations
Further Information

Publication History

26 May 2019

21 June 2019

Publication Date:
08 August 2019 (online)

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Abstract

Background Anterior chest wall resection for oncological purposes is usually combined with a form of reconstruction. Most surgeons are convinced that ventrally located defects more than 4 to 5 cm require adequate reconstruction to minimize the risk of lung herniation and respiratory distress through paradox motion. We describe our in-house results of ventral chest wall reconstruction using polypropylene mesh without the use of metallic or biological implants regardless of the extent of chest wall resection.

Methods Patient selection involved ventral chest wall resection and reconstruction by polypropylene mesh for all indications such as primary tumors, metastasis, or infiltration by lung cancer from January 2008 to December 2016. Primary end point was the difference between both sides. Secondary end points were postoperative complications such as infection, surgical revision, and pulmonary complications.

Results Forty-five cases of isolated anterior reconstruction could be identified. In 34 cases, postoperative computed tomography scan of the thorax was available. Fifteen males and 19 females with a median age of 70.5 years were operated. The evaluation of maximum hemithorax diameter between operated and nonoperated sides was documented in centimeters, and the difference was documented in percentage. The mean percentage difference was 11.1% (minimum: 0.3, maximum: 44.4). In one case, wound infection with positive culture could not be treated conservatively and required operative revision and removal of the polypropylene mesh.

Conclusion Polypropylene mesh, though not rigid, can safely be used for anterior chest wall reconstruction.

Keywords

chest - chest wall - sternum - surgery - complications
 

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