The contribution of microvascular free flaps and pedicled flaps to successful chest wall surgery.


Journal

The Journal of thoracic and cardiovascular surgery
ISSN: 1097-685X
Titre abrégé: J Thorac Cardiovasc Surg
Pays: United States
ID NLM: 0376343

Informations de publication

Date de publication:
10 2023
Historique:
received: 13 03 2023
revised: 25 04 2023
accepted: 09 05 2023
pmc-release: 01 10 2024
medline: 15 9 2023
pubmed: 27 5 2023
entrez: 26 5 2023
Statut: ppublish

Résumé

Pedicled flaps (PFs) have historically served as the preferred option for reconstruction of large chest wall defects. More recently, the indications for microvascular-free flaps (MVFFs) have increased, particularly for defects in which PFs are inadequate or unavailable. We sought to compare oncologic and surgical outcomes between MVFFs and PFs in reconstructions of full-thickness chest wall defects. We retrospectively identified all patients who underwent chest wall resection at our institution from 2000 to 2022. Patients were stratified by flap reconstruction. End points were defect size, rate of complete resection, rate of local recurrence, and postoperative outcomes. Multivariable analysis was performed to identify factors associated with complications at 30 days. In total, 536 patients underwent chest wall resection, of whom 133 had flap reconstruction (MVFF, n = 28; PF, n = 105). The median (interquartile range) covered defect size was 172 cm Patients with MVFFs had larger defects, a high rate of complete resection, and a low rate of local recurrence. MVFFs are a valid option for chest wall reconstructions.

Identifiants

pubmed: 37236598
pii: S0022-5223(23)00439-7
doi: 10.1016/j.jtcvs.2023.05.018
pmc: PMC10528168
mid: NIHMS1910311
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1262-1272.e2

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

Copyright © 2023 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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Auteurs

Stijn Vanstraelen (S)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Barkat Ali (B)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Manjit S Bains (MS)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Farooq Shahzad (F)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Robert J Allen (RJ)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Evan Matros (E)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Joe Dycoco (J)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Prasad S Adusumilli (PS)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Matthew J Bott (MJ)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Robert J Downey (RJ)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

James Huang (J)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

James M Isbell (JM)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Daniela Molena (D)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Bernard J Park (BJ)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Valerie W Rusch (VW)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Smita Sihag (S)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Peter G Cordeiro (PG)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Michelle R Coriddi (MR)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Joseph H Dayan (JH)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Joseph Disa (J)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Colleen M McCarthy (CM)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Jonas A Nelson (JA)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Carrie Stern (C)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Babak Mehrara (B)

Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

David R Jones (DR)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Fiona and Stanley Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY.

Gaetano Rocco (G)

Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; Fiona and Stanley Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: roccog@mskcc.org.

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