Rigid prosthesis removal following chest wall resection and reconstruction for cancer

Background: Composite rigid mesh is one of the most widely used prostheses for chest wall reconstruction after chest wall resection for neoplastic disease, but few data are available on prosthesis stability, dislocation and infections after long-term follow-up. The aim of this study was to assess the indications for chest wall prosthesis removal, technique and postoperative outcome. Methods: A total of 166 consecutive patients underwent chest wall resection and reconstruction by rigid prosthesis over an 18-year period and—among them—10 patients (6.0%) required prosthesis removal. Results: The indications for prosthesis removal were: infection (8 pts: 80%); neoplastic recurrence (2 pts: 20%). Reconstruction following prosthesis removal was: absorbable mesh in three cases (30%), no prosthesis in four patients (40%), other in 2 patients (20%) (1 rigid prosthesis, 1 Gore-tex® prosthesis). Conclusions: Composite rigid mesh removal is indicated in case of prosthesis infection or, rarely, to treat chest wall recurrence at the edges of the prosthesis. Reconstruction after prosthesis removal may require soft mesh but very often no new prosthesis is needed due to fibrosis stabilizing the chest wall.