P-267
A LOW COST METHOD FOR CHEST WALL RECONSTRUCTION AFTER RESECTION FOR TUMOURS

Objectives: Chest wall tumours are very common and are suited for wide resections with oncologic margin, the reconstruction and stabilization of the thorax is crucial for the outcome of these patients. There are many high-tech solutions for this problem that imply high costs. We present our experience using low-cost materials.

Methods: We analysed a series of 184 patients that underwent surgery in our department in a 14-year period (2001–2014), aged between 21 and 74 years. Hundred and thirty-five patients had primary, secondary or contiguous malignancies of the chest wall. The surgical procedures applied were chest wall resection followed by reconstruction (74.6% of cases) with several types of low cost synthetic materials such as methylmetacrylate, reinforced marlene mesh, or the use of interlaced tension suture of the defect, including after subtotal sternectomy, as follows: we placed the stiches all alongside the defect margin, we tied them toghether to obtain a tensioned, interlaced web similar to a spider web to cover all the defect area. We covered the web using vicinity muscle flaps. 25.4% of the cases required no stabilization.

Results: In all the cases there was no perioperative mortality. The mean hospital stay was 8 days. The immediate postoperative outcome of the patients was good in 180 cases, 3 cases developed wound seroma that was managed by conservative treatment and one patient underwent a second surgery using muscular flap after stabilization with methylmetacrylate (rejected material).

Conclusions: Although very cheap, methylmetacrylate did cause rejection and further surgery was necessary. The usage of the interlaced tension non-resorbable stiches for the suture of the defect provided optimal stabilization of the chest wall, with no morbidity and fulfilled our expectations. Taking into account the low cost of the materials, we consider this method optimal for units in low/middle income countries.

Disclosure: No significant relationships.