Surgical complication and postoperative pulmonary function in patients undergoing tumor surgery with thoracic wall resection

Abstract

Postoperative complications of thoracic wall resection include respiratory complications, skin necrosis and infection. The aim of the present study was to examine postoperative complications in patients who required combined thoracic wall resection during the surgical removal of a tumor. The present study included 68 patients; there were 50 patients with lung tumors and 18 patients with musculoskeletal tumors. The clinical factors associated with complications were compared between the two groups. Preoperative and postoperative pulmonary function tests were performed to examine the residual pulmonary function in 16 patients. Thoracic cage reconstruction was performed in 46 patients. Postoperative complications occurred in 30 (44.1%) patients, and one patient died from postoperative pneumonitis. Compared with the pulmonary function preoperative test results, the postoperative results revealed a decrease in the mean vital capacity percentage and an increase in the mean forced expiratory volume within 1 sec as a percent of the forced vital capacity. In patients with lung tumors, pneumonectomy can result in an increased rate of complications following thoracic wall resection. Residual pulmonary function is affected by impaired thoracic cage expansion and removal of the lung. However, the results of the present study demonstrated that these complications can be somewhat stabilized by thoracic wall reconstruction.

Chest wall resection and reconstruction for lung cancer: surgical techniques and example of integrated multimodality approach

“…Respiratory complications are an important source of morbidity after chest wall resection, in particular in elderly patients (45) or in case of combined pneumonectomy (46). Thus, careful patient selection and availability of specialized facilities for postoperative care are mandatory to limit postoperative deaths.…”

Chest wall reconstruction in benign and malignant tumors with non-rigid materials: An overview

“…After the first search, 1,343 records were found, and a second selection was made by the title, extracting 102 papers. Of these 102 papers, 16 were finally chosen for review (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Studies evaluating the combination of rigid and semi-rigid prostheses were included only if a subgroup analysis for semirigid materials was done.…”

Chest Wall Reconstruction With 3D Printing: Anatomical and Functional Considerations

“…30 32,33 In contrast, a recent study of 16 patients by Hayashi et al found a reduction in VC (24.6%, P < 0.01) and an increase in FEV 1 (16.3%, P < 0.01). 34 However, they noted that the decreased VC in 13 of the 16 patients was related to patients having had a pneumonectomy, and patients had a trend toward a restrictive pattern of dysfunction. 34…”

“…34 However, they noted that the decreased VC in 13 of the 16 patients was related to patients having had a pneumonectomy, and patients had a trend toward a restrictive pattern of dysfunction. 34…”

“…15,29,31,33 Moreover, patients who undergo lung resection, such as a pneumonectomy, in addition to chest wall resection and reconstruction, may demonstrate a significant decrease in their VC. 34 The chest wall is a dynamic structure that is constantly active in respiration. For normal kinesiology of breathing, the joints and muscles in the region must be sufficiently mobile, compliant, and coordinated for the thorax to function as a mechanical chamber for respiration, including coughing and forced exhalation.…”