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7.P.17 A NEW METHOD OF RECONSTRUCTION FOLLOWING FULL THICKNESS CHEST WALL RESECTIONS



Abstract

Chondrosarcoma is an uncommon primary malignancy of cartilage. This tumour tends to be resistant to both chemotherapy and radiotherapy making surgical resection the primary treatment. These tumours can present on the chest wall, requiring multidisciplinary team input at the time of surgery, involving orthopaedic, cardiothoracic and plastic surgeons. Complete excision, ensuring adequate resection margins, requires removal of ribs and pleura resulting in a full thickness chest wall defect. Complex reconstruction techniques are necessary to prevent post-operative morbidity of chest wall indrawing and reduced pulmonary function. Reconstruction can be considered in two parts, the reconstruction of the rigid support and the necessary soft tissue cover. In the past a number of options have been available to provide the rigid support, marlex sandwich, prolene mesh and autologous bone grafting. Each of these techniques has potential disadvantages.

We describe two patients who underwent resection of chest wall chondrosarcomas. These patients had reconstruction of the rigid chest wall support using STRATOS (STRASBOURG Thoracic Osteosyntheses System). This system utilises clamps around the cut ends of the ribs to provide the necessary rigid support, eliminating some of the disadvantages of the older techniques. Both patients made an uncomplicated post-operative recovery.

The STRATOS implant was easily used and versatile, providing an immediately secure and rigid fixation in chest wall reconstruction.

Correspondence should be addressed to Professor Stefan Bielack, Olgahospital, Klinikum Stuttgart, Bismarkstrasse 8, D-70176 Stuttgart, Germany. Email: s.bielack@klinikum_stuttgart.de