Thoracic wall reconstruction with bioabsorbable plates in pediatric malignant thoracic wall tumors

Abstract

AimChildhood malignant chest wall tumors may require extensive surgical resection and reconstruction with musculoskeletal flaps or non-resorbable prosthetic materials. Implant-related complications and scoliosis often occur. This study analyzes the outcomes of chest wall reconstruction using resorbable plates as an alternative approach. MethodsRetrospective review (2007–2015) of patients who underwent resection of malignant primary chest wall tumors in 2 tertiary pediatric centers. Reconstruction was performed using copolymer (l-lactic and glycolic acid) plates, fixed to the ribs and surrounding structures with copolymer screws and/or polyglactin sutures. ResultsEight patients aged 10.6+2.6years were treated. There were no operative complications, and implant removal was not required in any case. Six patients received postoperative radiotherapy. Over follow-up (39.6months, range 9.4–78), chest wall shape was maintained in all, and there were no radiological artifacts. Three patients developed scoliosis (Cobb 17°–33°), but treatment was needed only in one, who had undergone hemivertebrectomy. There were no cases of local tumor relapse. One patient died because of metastatic spread. ConclusionsImplantation of bioabsorbable l-lactic and glycolic acid copolymer plates with a relatively simple technique provided a rigid, stable reconstruction with only mild mid-/long-term complications. Resorbable plates may be a good alternative for pediatric chest wall reconstruction.Level of evidence: IV.