XXXX and prosthetic reconstruction: A comparative analysis on functional outcome.

@entity1 @entity1223 @entity5 @entity260 @entity358
BACKGROUND: To address the question of how much chest-wall (CW) resections and prosthetic reconstructions influence functional outcome. METHODS: We retrospectively reviewed 175 @entity1 who underwent surgery for CW @entity5 . The clinical, histological, surgical, oncological, and functional factors were analyzed. RESULTS: We performed: 75 rib resections; 20 sternal resections; 15 combined resections; and 27 lung resections. In 39 cases (22.2%) CW was stabilized with non-rigid prosthesis (Vicryl-mesh: 8 @entity1 ; Goretex-mesh: 31 @entity1 ). @entity260 occurred in 22 cases (12.6%): a correlation with lung resection was evidenced by multivariate analysis (P = 0.025). Five-year survival for primary and secondary @entity5 was 50% and 36%, respectively: multivariate analysis (P = 0.048) showed a worse survival in @entity1 only. In the prosthesis subset, pulmonary function tested as percentage of forced expiratory volume in one second (%FEV1) (pre: 87.1    18.9%; post: 82.3    23.0%, P = ns), percentage of forced vital capacity (pre: 94.1    19.3%; post: 82.0    21.6%, P = ns), diffusing capacity of the lungs for @entity1223 (pre: 15.7    7.4; post: 12.1    4.1, P = ns) and paO2 (pre: 82.6    10.9   mmHg; post: 83.9    7.3   mmHg, P = ns) was slightly modified from pre to postoperative. Interestingly, the decline of FEV1% was lower in the prosthesis-subset (4.1    15.9%) compared with the subgroup who did not undergo prosthetic stabilization (17.5    16.2%), but this difference was not statistically significant (P = ns). CONCLUSION: Because of the low decrease of lung parameters, CW prosthetic reconstruction could be helpful for avoiding postoperative worsening of functional outcome, mostly in @entity1 with pre-existing @entity358 .
