Chest wall resection and reconstruction

Chest wall resections involve the removal of diseased osseous and soft tissues affected by primary or secondary neoplasms, as well as infections. In most cases the aim is a radical oncologic resection, although palliative surgeries are sometimes indicated. The extent of the resection, including clear margins, has to be planned in advance, together with the required reconstruction. The chest wall reconstruction has to provide structural support as well as adequate coverage with healthy soft tissue. Available alternatives for support include autologous and heterologous grafts, titanium implants or synthetic membranes. A thoracic surgeon performing these reconstructions should also be comfortable with basic techniques of soft tissue coverage using myocutaneous flaps. Metal three-dimensional printing of custom implants with biomechanical designs may allow for a truly functional reconstruction in complex cases.