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Five-year experience with titanium mesh for rigid chest wall reconstruction

Year: 2024
Type: article
Study design: Observational Study
Abstract: Objective: To characterize the performance of titanium mesh (TM) (off-label) for rigid chest wall reconstruction at a single institution over a 5-year period. Methods: Between January 1, 2019, and May 15, 2023, 22 patients (median age, 61 years) underwent chest wall resection with TM reconstruction at Cleveland Clinic. Indications for resection included sarcoma (n = 15), breast cancer (n = 2), lung cancer (n = 2), chondroblastoma (n = 1), and benign neoplasm (n = 2). Patients were followed every 6 months with computed tomography scans for cancer recurrence. Continuous variables are summarized as median (interquartile range [IQR]); categorical variables, as frequency and percentage. Time to mesh fracture was assessed nonparametrically using Kaplan-Meier analysis. Results: ). No patient experienced respiratory complications or mesh failure postoperatively. Of the 3 reoperations (13.6%), 2 were for delayed regional infection (at 7 and 12 months postoperatively), necessitating localized mesh removal, and the third was for local cancer recurrence. Fifteen implants developed visible fractures on imaging at a median time of 9 months after implantation. There were no adverse sequelae, including migration/erosion or clinical decline in respiratory function. Conclusions: Chest wall resections, particularly those for sarcomas, require large margins for optimal oncologic outcomes. Rigid reconstruction of large defects is desirable, yet options are limited. TM reconstruction provides a promising alternative because of its biocompatibility, rigidity, robust incorporation into surrounding structures, and resistance to infection.
DOI: 10.1016/j.xjtc.2024.08.016
Institution: Cleveland Clinic
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,431
OpenAlex ID: W4402168777
FWCI: 1.034
Cites: 15
Cited by: 4
Related to: 10