Chest Wall Procedures

Abstract

Chest wall procedures are an important component of any thoracic surgeon’s practice. The approach to these procedures is somewhat different from the approach to esophageal or pulmonary resections and requires specific knowledge of thoracic musculoskeletal anatomy, as well as of the different types of autologous and artificial grafts available for chest wall reconstruction. This review covers chest wall procedures, broadly divided into procedures for congenital chest wall disease and procedures for acquired chest wall disease. The major surgical techniques in both categories are described, and the pitfalls that may accompany them are reviewed. Figures show the various steps used in repair of pectus excavatum (Ravitch procedure and Nuss procedure), transaxillary first rib resection, chest wall resection, manubrial resection and reconstruction, and open chest drainage (Eloesser flap), as well as a chest computed tomographic scan revealing a large pulmonary and chest wall mass. This review contains 16 figures and 49 references. Keywords: Pectus repair, Chest wall reconstruction, First rib resection, Sternoclavicular osteomyelitis