Radical surgery of lungcancer with chest wall invasion and reliable methods of chest wall reconstruction

Abstract

：Objective To study theefficacy of radical surgery for the invasion of chest wall by lung cancers and thedifferent methods of chest wall reconstruction. Methods A retrospective analysis ofclinical data was conducted in 27 cases of lung cancer with chest wall invasion in thishospital. 24 cases received lobectomy, 3 cases received pneumonectomy, and all casesreceived wall reconstruction. The size of chest wall defect after resection ranged from6.5 cm × 5.4 cm × 5.0 cm to 15.5 cm × 12.5 cm ×10.0 cm. The number of rib resectionfor each patient ranged from 1 to 4. The reconstructive methods were as follows: usingpolyester fabric to reconstruct costal pleura, using plexiglass, stainless steel wire andgrid-like titanium plate to reconstruct bone defect, and using nearby muscle flap andpedunculated muscle flap to reconstruct muscle defect. Results Pathologic diagnosis wasnon-small cell lung cancer,including 22 cases of squamous cell carcinomas and 5adenocarcinomas. There were pulmonary infections in 6 cases, chest hemorrhage in 1 caseand chest purulence in 1 case. One-year survival was 77. 9 %,3-yearsurvival was 58.3 %,and 5-year survival was 29. 1 %. Conclusion The lung cancer with chest wall invasion isadvisable to make active use of radical surgery. The different methods and repairmaterials are chosen to reconstruct the chest wall defect, supplemented by comprehensivetreatments.