I tumori della parete toracica

The aim of this work was to evaluate the different surgical repair procedures and to discuss their technical applications according to the indications. From april 1989 to november 1999 we observed 18 patients, 12 males (66.7%) and 6 females (33.3%) presenting tumors of the chest wall. All patients were submitted preoperatively to a general respiratory check-up, and to an assessment of loco-regional and metastatic lesions. In 13 patients (72.2%), on the basis of topographical and morphological characteristics of the mass, we performed a transthoracic needle biopsy under scanner monitoring. The exeresis, in 6 patients (33.3%), implied a large resection of osteo-muscular structures. In 10 patients (55.6%), the benign nature of lesion, required extirpation solely of the tumor. In 2 patients (11.1%), owing to the extensive infiltration of the primary neoplasm, solely complementary treatment was carried out. Reconstruction of the thoracic wall was performed using associated myoplasty in all cases. In 3 subjects a prosthesis was installed; in 1 case a costal transposition association is necessary. Histological observation of the excised material revealed 16 primary tumors, 12 benign (75%) and 4 malignant (25%). Transthoracic needle biopsy under scanner monitoring confirmed the diagnosis in 100% of the cases operated. Fourteen patients (87.5%) are alive 73 +/- 35 months after intervention, without resumption of the disease. Two patients died (12.5%) VIII and VI months following the operation. Two patients not operated, died after VI and V months. Appropriate choice of techniques and of repair materials allowed valid oncological, aesthetical and functional results independently from the extent of the parietal defect.