FROM RESECTION TO RESTORATION: ASSESING THE SYNERGY OF POLYPROPYLENE MESH (MARLEX®) COMBINED TO METHYL-METHACRYLATE AND LATISSIMUS DORSI FLAP FOR PRIMARY CHEST WALL SARCOMAS

Abstract

BackgroundChest wall sarcomas are treated with extensive resections and complex defect reconstruction to restore chest wall integrity. It's a difficult surgical procedure that necessitates a multidisciplinary approach for the best outcome, preventing paradoxical chest movement issues, and reducing complications. ObjectiveThis study aims to describe our experience of chest wall reconstruction using Polipropylene mesh (Marlex® Mesh) combined to methyl-methacrylate and soft tissue coverage with a latissimus dorsi flap following sarcoma resection. Patients and MethodsOut of 53 patients treated for primary chest wall sarcomas at the European Institute of Oncology (IEO) in Milan, Italy, from 1998 to 2020, 14 cases underwent chest wall resection and reconstruction using polypropylene mesh, methyl-methacrylate, and the latissimus dorsi flap.Patients with locally advanced breast cancers, locally advanced lung cancers, squamous cell carcinomas, and other secondary chest wall malignancies were excluded from the study, as were patients with different types of chest wall reconstruction. ResultsIn this study, 14 patients (6 males and 8 females) with various primary chest wall sarcomas were enrolled. On average, 2 ribs were removed during the surgeries (range: 1-5), and the chest wall defects ranged from 20 to 150 cm2 with an average size of 73 cm2. The mean follow-up period for these patients was approximately 63.80 months ConclusionThe combination of Marlex® mesh filled with methyl-methacrylate and latissimus dorsi myocutaneous flap provides a safe, low-cost, and effective one-stage chest wall reconstruction after surgery for primary sarcomas.